Vito Chiantera1, Martina Rossi, Pierandrea De Iaco, Christardt Koehler, Simone Marnitz, Anna Fagotti, Francesco Fanfani, Fabio Parazzini, Riccardo Schiavina, Giovanni Scambia, Achim Schneider, Giuseppe Filiberto Vercellino. 1. *Department of Gynecology and Gynecological Oncology, Campus Mitte (CCM) and Campus Benjamin Franklin (CBF), Charitè University, Berlin, Germany; †Gynecologic Oncology Unit, S. Orsola-Malpighi Hospital, Alma Mater Studiorum University of Bologna, Bologna, Italy; ‡Department of Radiooncology, Campus Mitte (CCM) and Campus Virchow (CVK), Charitè University, Berlin, Germany; §Gynecologic Oncology Unit, Catholic University of the Sacred Heart, Rome, Italy; ∥Università di Milano, Fondazione Policlinico Milano, Milan, Italy; ¶Department of Urology, S. Orsola-Malpighi Hospital, Alma Mater Studiorum University of Bologna, Bologna, Italy; and #Gynecologic Oncology Unit, Catholic University of the Sacred Heart, Campobasso, Italy.
Abstract
OBJECTIVE: Our study purpose was to evaluate morbidity and postoperative mortality in patients who underwent pelvic exenteration (PE) for primary or recurrent gynecological malignancies. METHODS: We identified 230 patients who underwent PE, referred to the gynecological oncology units of 4 institutions: Charitè University in Berlin, Friedrich-Schiller University in Jena, S. Orsola-Malpighi University in Bologna, and Catholic University in Rome and in Campobasso. RESULTS: The median age was 55 years. The tumor site was the cervix in 177 patients, the endometrium in 28 patients, the vulva in 16 patients, and the vagina in 9 patients. Sixty-eight anterior, 31 posterior, and 131 total PEs were performed in 116 women together with hysterectomy. A total of 82.6% of the patients required blood transfusion. The mean operative time was 446 (95-970) minutes, and the median hospitalization was 24 (7-210) days. We noted a major complication rate of 21.3% (n = 49). We registered 7 perioperative deaths (3%) calculated within 30 days. The operation was performed within clear margins in 166 patients (72.2%). The overall mortality rate depending on tumor site at the end of the study was 75% for vulvar cancer, 57.6% for cervical cancer, 55.6% for vaginal cancer, and 53.6% for endometrial cancer. CONCLUSIONS: Although an important effort for surgeons and for patients, PE remains a therapeutic option with an acceptable complication rate and postoperative mortality. A strict selection of patients is mandatory to reach adequate surgical and oncologic outcomes.
OBJECTIVE: Our study purpose was to evaluate morbidity and postoperative mortality in patients who underwent pelvic exenteration (PE) for primary or recurrent gynecological malignancies. METHODS: We identified 230 patients who underwent PE, referred to the gynecological oncology units of 4 institutions: Charitè University in Berlin, Friedrich-Schiller University in Jena, S. Orsola-Malpighi University in Bologna, and Catholic University in Rome and in Campobasso. RESULTS: The median age was 55 years. The tumor site was the cervix in 177 patients, the endometrium in 28 patients, the vulva in 16 patients, and the vagina in 9 patients. Sixty-eight anterior, 31 posterior, and 131 total PEs were performed in 116 women together with hysterectomy. A total of 82.6% of the patients required blood transfusion. The mean operative time was 446 (95-970) minutes, and the median hospitalization was 24 (7-210) days. We noted a major complication rate of 21.3% (n = 49). We registered 7 perioperative deaths (3%) calculated within 30 days. The operation was performed within clear margins in 166 patients (72.2%). The overall mortality rate depending on tumor site at the end of the study was 75% for vulvar cancer, 57.6% for cervical cancer, 55.6% for vaginal cancer, and 53.6% for endometrial cancer. CONCLUSIONS: Although an important effort for surgeons and for patients, PE remains a therapeutic option with an acceptable complication rate and postoperative mortality. A strict selection of patients is mandatory to reach adequate surgical and oncologic outcomes.
Authors: Yulia Lakhman; Stephanie Nougaret; Maura Miccò; Chiara Scelzo; Hebert A Vargas; Ramon E Sosa; Elizabeth J Sutton; Dennis S Chi; Hedvig Hricak; Evis Sala Journal: Radiographics Date: 2015 Jul-Aug Impact factor: 5.333
Authors: H G Schnürch; S Ackermann; C D Alt; J Barinoff; C Böing; C Dannecker; F Gieseking; A Günthert; P Hantschmann; L C Horn; R Kürzl; P Mallmann; S Marnitz; G Mehlhorn; C C Hack; M C Koch; U Torsten; W Weikel; L Wölber; M Hampl Journal: Geburtshilfe Frauenheilkd Date: 2016-10 Impact factor: 2.915
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