M J Lopez1, S B Standiford, J L Skibba. 1. Department of Surgery, St Elizabeth's Medical Center of Boston, Tufts University School of Medicine, Mass.
Abstract
OBJECTIVE: To review a 50-year experience with total pelvic exenteration for treatment of advanced pelvic cancer. DESIGN: Retrospective study with 100% follow-up. SETTING: Cancer hospital. PATIENTS: Two hundred thirty-two patients referred for treatment of advanced pelvic cancer who underwent total pelvic exenteration. MAIN OUTCOME MEASURES: Rates of operative mortality, complications, recurrence, and 5-year survival. RESULTS: The morbidity rate was 45%. The operative death rate was 14% during the 50-year period, but decreased from 16.8% in the first three decades to 10% thereafter. Eighty-nine patients (38%) had recurrences. The overall 5-year survival rate was 42%. CONCLUSIONS: Operative mortality and morbidity have declined over 50 years, largely because of proper patient selection, increasing experience, and advances in perioperative care. Exenteration has a major role in the treatment of advanced pelvic cancer.
OBJECTIVE: To review a 50-year experience with total pelvic exenteration for treatment of advanced pelvic cancer. DESIGN: Retrospective study with 100% follow-up. SETTING:Cancer hospital. PATIENTS: Two hundred thirty-two patients referred for treatment of advanced pelvic cancer who underwent total pelvic exenteration. MAIN OUTCOME MEASURES: Rates of operative mortality, complications, recurrence, and 5-year survival. RESULTS: The morbidity rate was 45%. The operative death rate was 14% during the 50-year period, but decreased from 16.8% in the first three decades to 10% thereafter. Eighty-nine patients (38%) had recurrences. The overall 5-year survival rate was 42%. CONCLUSIONS: Operative mortality and morbidity have declined over 50 years, largely because of proper patient selection, increasing experience, and advances in perioperative care. Exenteration has a major role in the treatment of advanced pelvic cancer.
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