Does Histologic Type Correlate to Outcome after Pelvic Exenteration for Cervical and Vaginal Cancer?

Abstract

AC histology in cervical and vaginal cancer is associated with better outcome after PE compared to SCC.

Pelvic Exenteration for Recurrent and Persistent Cervical Cancer

“…We failed, however, to find a significant relationship between the surgical level and marginal status of incisions. Other risk factors of survival included the size of tumors,[ 10 11 ] DFS after primary treatment,[ 11 ] pathological subtypes of malignancies,[ 28 ] metastasis to the mesorectal[ 29 30 31 ] or retroperitoneal[ 32 33 ] lymph nodes, and LVSI. We checked all these factors in the study and found that metastasis to mesorectal lymph nodes and marginal status of the incision remained independent risk factors both for OS and DFS.…”

Curative anterior pelvic exenteration for pelvic recurrence after irradiated, surgically treated cervical cancer. A case report and literature review

“…However, the decision of performing of such a radical procedure should be taken after a profound evaluation of several factors such as size of the tumor, disease free survival, histopathological subtype or the presence of lymph node invasion at the moment of the initial surgical procedure (2) . Therefore, patients presenting larger than 5 cm recurrences diagnosed after a disease free survival period shorter than 2 years with squamous cell histology have a poor prognosis in terms of survival even if a curative intent surgical procedure is performed (2,5,10,11) . As for the presence of lymph node invasion at the moment at the initial diagnosis, controversial opinions exist: while some authors consider that lymph node metastases at the time of initial diagnosis represent a negative prognostic factors (12,13) , other conclude that the lymph node status does not influence the overall survival after resection (14,15) .…”

Indications, techniques and outcomes for pelvic exenteration in gynecological malignancy

“…Combined OS for primary and secondary pelvic exenteration is reported around 41-70% [2][3][4][5][6][7][8]13] with a 5Y-OS of 20-73% [1][2][3][4][5][6][7]13,15], whereas a 5Y-OS of 10-27% is reported in the palliative setting [2,13,15,16 & ,49], which is better when compared with alternatives such as chemo-/radiotherapy [15]. Höckel [19] reported an OS of 55% and a 5Y-OS of 62% after LEER(N ¼ 100, followup ¼ 30 months).…”

“…Pelvic exenteration denotes en bloc removal of multiple viscera and is indicated when no other curative option is left to accomplish local disease control [1][2][3][4][5][6][7][8][9][10][11]12 & ,13]. Total pelvic exenteration defines resection of the female genital tract with salvage of the entire pelvis, including bladder, ureters and anorectum; anterior pelvic exenteration and posterior pelvic exenteration designate resection of solely the distal urinary tract and anorectum as adjacent pelvic organs, respectively.…”

“…Total pelvic exenteration defines resection of the female genital tract with salvage of the entire pelvis, including bladder, ureters and anorectum; anterior pelvic exenteration and posterior pelvic exenteration designate resection of solely the distal urinary tract and anorectum as adjacent pelvic organs, respectively. As its first description [14], perioperative mortality has dropped from 20 to less than 5% [2,3,5], while postoperative 5-year survival (5YS) has reached 20-73% [1][2][3][4][5][6][7][8][9][10][11]12 & , 13, 15,16 & ], displaying a remarkable evolution from palliation to a potential cure [1][2][3][4][5]13,15]. As its first description [14], perioperative mortality has dropped from 20 to less than 5% [2,3,5], while postoperative 5-year survival (5YS) has reached 20-73% [1][2][3][4][5][6][7][8][9][10][11]12 & , 13, 15,16 & ], displaying a remarkable evolution from palliation to a potential cure [1]…”