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Background: Pelvic exenteration (PE) may be associated with prolonged overall survival (OS) in selected patients with advanced or recurrent cervical cancer. However, the factors related to improved survival following PE are not clearly defined. The aim of this study was to perform a retrospective analysis of OS rates in a group of patients undergoing PE in order to identify the factors related to improved long-term outcomes. Methods: Our study group consisted of 44 patients, including 21 squamous cell cancer (SCC) patients, 22 patients with adenocarcinomas (AC) of the cervix, and one patient with undifferentiated cervical carcinoma. The patients were categorized according to the type of surgery, namely, primary surgery (12 patients) or surgery due to cancer recurrence (32 patients). Results: In the group of patients with recurrent cervical cancer, we found that improved OS correlated with the SCC histological type and the presence of vaginal fistula. The need for reoperation within 30 days and the presence of severe adverse events significantly worsened the prognosis. We found a non significant trend toward improved survival in those patients with tumor-free margins. Lymph node metastases, the initial stage of the disease, the time to recurrence, and a history of hysterectomy had no impact on patients' OS. In the group of patients undergoing primary PE, we observed a trend toward improved survival among those diagnosed with vaginal fistula. Conclusions: Pelvic exenteration seemed to improve the long-term outcomes for patients with SCC cancer recurrence and vaginal fistula whose surgery was unrelated to severe adverse events.

<b><i>Introduction:</i></b> Surgery for advanced ovarian cancer (AOC) often requires bowel resections. However, the impact of bowel surgery on patient overall survival (OS) has not yet been precisely determined. <b><i>Objective:</i></b> The aim of the study was to analyze the OS rates in a group of AOC patients undergoing bowel resection. <b><i>Methods:</i></b> We carried out a retrospective analysis of patients who had undergone low anterior resection of the rectum (LAR) during primary or interval debulking surgery for AOC. We divided the patients into 2 groups: Group 1 included 69 patients who underwent only LAR; Group 2 included 66 patients who underwent LAR and additional bowel resection. The control group included 71 AOC patients who did not required bowel resection. <b><i>Results:</i></b> In the subgroup of patients with no gross residual disease (NGR), there were no differences in OS between Groups 1 and 2. In the subgroup of “optimally” (tumors &#x3c;1 cm) debulked patients, Group 1 patients had a higher median OS than Group 2 patients. Additionally, there was no difference between Groups 1 and 2 as far as the number of severe adverse events. <b><i>Conclusions:</i></b> Multiple bowel resections seem to improve OS in patients when NGR is achieved but should be avoided when complete resection is not possible.

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AimStandard treatment for locally advanced cervical cancer patients (LACC) consists of chemoradiation followed by vaginal brachytherapy. However, many patients with LACC surgery undergo surgical treatment with hysterectomy during comprehensive cancer treatment. The aim of the present study has been to analyze the survival data of those who underwent hysterectomy due to vaginal bleeding or hemorrhage prior to definitive chemoradiation. Materials and methodsThe study group included 35 patients with stage IIB (according to the FIGO classification) cervical cancer who received chemoradiation following salvage hysterectomy performed because of severe bleeding. The control group consisted of 44patients with stage IIB cervical cancer treated with primary chemoradiation without completion hysterectomy. ResultsThe median period for patient follow-up was 100 months. We did not observe inferior survival rates among the patients treated with salvage hysterectomy prior to chemoradiation compared to those treated with chemoradiation alone (P=0.77). The 5-year survival rate for patients treated with initial surgery was 62% compared to 61% for those treated with primary chemoradiation. Six (17%) patients from the group treated with hysterectomy experienced severe adverse events. ConclusionWhen hysterectomy due to vaginal bleeding or hemorrhage in patients with locally advanced cervical cancer is performed prior to chemoradiation, it may have curative significance and provide some overall survival benefit.