Pelvic exenteration for colorectal and non-colorectal cancer : a comparison of perioperative and oncological outcome
© 2021. The Author(s)..
BACKGROUND: Pelvic exenteration (PE) is the only option for long-term cure of advanced cancer originating from different types of tumor or recurrent disease in the lower pelvis. The aim was to show differences between colorectal and non-colorectal cancer in survival and postoperative morbidity.
METHODS: Retrospective data of 63 patients treated with total pelvic exenteration between 2013 and 2018 are reported. Pre-, intra-, and postoperative parameters, survival data, and risk factors for complications were analyzed.
RESULTS: A total of 57.2% (n = 37) of the patients had colorectal cancer, 22.3% had gynecological malignancies (vulvar (n = 6) or cervical (n = 8) cancer), 11.1% (n = 7) had anal cancer, and 9.5% had other primary tumors. A total of 30.2% (n = 19) underwent PE for a primary tumor and 69.8% (n = 44) for recurrent cancer. The 30-day in-hospital mortality was 0%. Neoadjuvant treatment was administered to 65.1% (n = 41) of the patients and correlated significantly with postoperative complications (odds ratio 4.441; 95% CI: 1.375-14.342, P > 0.05). R0, R1, R2, and Rx resections were achieved in 65.1%, 19%, 1.6%, and 14.3% of the patients, respectively. In patients undergoing R0 resection, 2-year OS and RFS were 73.2% and 52.4%, respectively. Resection status was a significant risk factor for recurrence-free and overall survival (OS) in univariate analysis. Multivariate analysis revealed age (P = 0.021), ASA ≥ 3 (P = 0.005), high blood loss (P = 0.028), low preoperative hemoglobin level (P < 0.001), nodal positivity (P < 0.001), and surgical complications (P = 0.003) as independent risk factors for OS.
CONCLUSION: Pelvic exenteration is a procedure with high morbidity rates but remains the only curative option for advanced or recurrent colorectal and non-colorectal cancer in the pelvis.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:36 |
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| Enthalten in: |
International journal of colorectal disease - 36(2021), 8 vom: 06. Aug., Seite 1701-1710 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Bogner, Andreas [VerfasserIn] |
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| Links: |
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| Themen: |
Journal Article |
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| Anmerkungen: |
Date Completed 16.07.2021 Date Revised 23.10.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00384-021-03893-y |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM322348978 |
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| 100 | 1 | |a Bogner, Andreas |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Pelvic exenteration for colorectal and non-colorectal cancer |b a comparison of perioperative and oncological outcome |
| 264 | 1 | |c 2021 | |
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| 500 | |a Date Completed 16.07.2021 | ||
| 500 | |a Date Revised 23.10.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2021. The Author(s). | ||
| 520 | |a BACKGROUND: Pelvic exenteration (PE) is the only option for long-term cure of advanced cancer originating from different types of tumor or recurrent disease in the lower pelvis. The aim was to show differences between colorectal and non-colorectal cancer in survival and postoperative morbidity | ||
| 520 | |a METHODS: Retrospective data of 63 patients treated with total pelvic exenteration between 2013 and 2018 are reported. Pre-, intra-, and postoperative parameters, survival data, and risk factors for complications were analyzed | ||
| 520 | |a RESULTS: A total of 57.2% (n = 37) of the patients had colorectal cancer, 22.3% had gynecological malignancies (vulvar (n = 6) or cervical (n = 8) cancer), 11.1% (n = 7) had anal cancer, and 9.5% had other primary tumors. A total of 30.2% (n = 19) underwent PE for a primary tumor and 69.8% (n = 44) for recurrent cancer. The 30-day in-hospital mortality was 0%. Neoadjuvant treatment was administered to 65.1% (n = 41) of the patients and correlated significantly with postoperative complications (odds ratio 4.441; 95% CI: 1.375-14.342, P > 0.05). R0, R1, R2, and Rx resections were achieved in 65.1%, 19%, 1.6%, and 14.3% of the patients, respectively. In patients undergoing R0 resection, 2-year OS and RFS were 73.2% and 52.4%, respectively. Resection status was a significant risk factor for recurrence-free and overall survival (OS) in univariate analysis. Multivariate analysis revealed age (P = 0.021), ASA ≥ 3 (P = 0.005), high blood loss (P = 0.028), low preoperative hemoglobin level (P < 0.001), nodal positivity (P < 0.001), and surgical complications (P = 0.003) as independent risk factors for OS | ||
| 520 | |a CONCLUSION: Pelvic exenteration is a procedure with high morbidity rates but remains the only curative option for advanced or recurrent colorectal and non-colorectal cancer in the pelvis | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Pelvic exenteration | |
| 650 | 4 | |a Rectal cancer | |
| 650 | 4 | |a Recurrence | |
| 650 | 4 | |a Surgical complication | |
| 650 | 4 | |a Survival | |
| 700 | 1 | |a Fritzmann, Johannes |e verfasserin |4 aut | |
| 700 | 1 | |a Müssle, Benjamin |e verfasserin |4 aut | |
| 700 | 1 | |a Huber, Johannes |e verfasserin |4 aut | |
| 700 | 1 | |a Dobroschke, Jakob |e verfasserin |4 aut | |
| 700 | 1 | |a Bork, Ulrich |e verfasserin |4 aut | |
| 700 | 1 | |a Wolk, Steffen |e verfasserin |4 aut | |
| 700 | 1 | |a Distler, Marius |e verfasserin |4 aut | |
| 700 | 1 | |a Weitz, Jürgen |e verfasserin |4 aut | |
| 700 | 1 | |a Welsch, Thilo |e verfasserin |4 aut | |
| 700 | 1 | |a Kahlert, Christoph |e verfasserin |4 aut | |
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