Total pelvic exenteration. A 50-year experience at the Ellis Fischel Cancer Center
M. J. Lopez, S. B. Standiford and J. L. Skibba
Department of Surgery, St Elizabeth's Medical Center of Boston, Tufts University School of Medicine, Mass.
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.
