Improvements in pelvic exenteration: Factors responsible for reducing morbidity and mortality

Jm, Goldberg; Ms, Piver; Re, Hempling; C, Aiduk; Blumenson, Leslie E.; Fo, Recio

doi:10.1007/bf02303857

Cited by 61 publications

(58 citation statements)

References 20 publications

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“…Today, combined pelvic surgery is used with curative intent in order to achieve radical resection and improve treatment results. According to latest data, a 5-year survival after pelvic exenteration is more than 50% [4][5][6][7]. Goldberg JM et al (1998) concluded that the indications for palliative exenteration should be exceptional and strictly individual, and, generally, this type of surgery should not be used for palliation [5].…”

Section: Discussionmentioning

confidence: 99%

“…According to latest data, a 5-year survival after pelvic exenteration is more than 50% [4][5][6][7]. Goldberg JM et al (1998) concluded that the indications for palliative exenteration should be exceptional and strictly individual, and, generally, this type of surgery should not be used for palliation [5]. Nguen DQ et al (2005) have not shown any survival improvement after palliative pelvic exenteration [7].…”

Section: Discussionmentioning

confidence: 99%

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Recurrent Ovarian Cancer with the Involvement of Urinary Organs: is There Place for Secondary Cytoreductive Surgery?

Kharchenko

2017

Galician med. j.

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The objective of the research was to estimate early and long-term results of secondary cytoreductive surgery performed for recurrent ovarian cancer with involvement of urinary organs. Materials and methods. The study included 62 patients with recurrent ovarian cancer treated in the Institute of General and Emergency Surgery named after V.T. Zaitsev of the Academy of Medical Sciences of Ukraine during January 2009 -September 2015. Selection criteria for secondary cytoreductive surgery were the following: recurrent ovarian cancer with involvement of the bladder and/or the ureter, no urologic surgery during primary cytoreductive surgery, the ECOG performance status of 0-2. Urological surgery that had been a subject to the analysis was the following: cystoscopy with or without intraoperative urethral stenting, bladder resection, ureterectomy, ureteral reimplantation, cystectomy with further reconstruction. Evaluation criteria included the presence and the level of surgical and postoperative urological complications within 30 days after surgery, relaparatomy rates, postoperative mortality, type of cytoreduction. Long-term results were evaluated through recurrence rates after secondary cytoreductive surgery, median survival, disease-free survival and overall survival. Results. Volumes of performed surgery (excluding urological one) were the following: lymphadenectomy (n=29; 46.7%), bowel resection (n=17; 27.4%), vascular resection (n=4; 6.5%) and others. Minimally invasive urological surgery included urethral stenting (n=6; 9.7%) and cystoscopy (n=13; 20.9%). Bladder resection was performed in 26 (41.9%) cases, cystectomy -in 17 (27.4%) cases. R0 resections were performed in all the cases. Postoperative non-urological complications were observed in 7 (11.2%) patients. Urological complications were found in 9 (14.5%) patients. Postoperative mortality was 3.2%. Recurrence was documented in 7 (11.3%) cases. Median survival was 24 months. Follow-up mortality was 30% (n=18). Conclusions. The results of combined secondary cytoreductive surgery performed for recurrent ovarian cancer with involvement of urinary organs indicate the possibility of en bloc resection of tumor and surrounding organs at acceptable rates of postoperative complications and mortality. Extended combined surgery and even pelvic exenteration are effective in treatment of patients with recurrent ovarian cancer. Keywords Problem statement and analysis of the recent researchTreatment of recurrent ovarian cancer (ROC) with multidisciplinary approach has been developed during the last decade. The collaboration of highly qualified specialists (chemotherapeutists, radiologists, oncogynecologists, oncourologists, vascular surgeons, etc.) allows to extend indications for secondary cytoreductive surgery (SCRS) and to increase the rate of optimal cytoreduction which are the principal factors for improved long-term outcomes.Topographic features of female pelvis contribute to local spread of ovarian cancer on the surrounding anatomical structures including u...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Recurrent Ovarian Cancer with the Involvement of Urinary Organs: is There Place for Secondary Cytoreductive Surgery?

Kharchenko

2017

Galician med. j.

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“…Mesmo com os avanços observados na área de radioterapia e quimioterapia, a ressecção com margens livres ainda é o único tratamento capaz de oferecer chance de cura para pacientes portadores de tumores pélvicos localmente avançados (Brunschwing e Daniel, 1954;Bricker et al, 1960;Symmonds et al, 1975;Rutledge et al, 1977;Rodriguez-Bigas e Petrelli, 1996;Goldberg et al, 1998).…”

Section: Aspectos Cirúrgicosunclassified

“…No decorrer dos anos foram identificados fatores responsáveis pelos melhores resultados obtidos com essa cirurgia (Lopez et al, 1994;Goldberg et al, 1998).…”

Section: Morbidade E Mortalidade Pós-operatóriasunclassified

“…Apesar do avanço tecnológico nas áreas de quimioterapia e radioterapia, estes métodos terapêuticos continuam insuficientes para o tratamento efetivo d os tumores pélvicos localmente avançados, sendo a cirurgia a principal modalidade terapêutica empregada e, a ressecção com margens livres, a única chance de cura para tais doentes (Brunschwing e Daniel, 1954;Bricker et al, 1960;Symmonds et al, 1975;Rutledge et al, 1977;Rodriguez-Bigas e Petrelli, 1996;Goldberg et al, 1998).…”

Section: Introductionunclassified

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Exenteração pélvica e preservação dos esfíncteres: análise de 96 casos

Poletto¹

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Pelvic exenteration for advanced pelvic malignancy

Crowe¹,

Temple²,

López³

et al. 1999

Semin. Surg. Oncol.

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Improvements in pelvic exenteration: Factors responsible for reducing morbidity and mortality

Abstract: Routine use of prophylactic antibiotics, prophylactic subcutaneous heparin, and intensive postoperative monitoring appear to have reduced morbidity from pelvic exenteration.

Cited by 61 publications

References 20 publications

Recurrent Ovarian Cancer with the Involvement of Urinary Organs: is There Place for Secondary Cytoreductive Surgery?

Recurrent Ovarian Cancer with the Involvement of Urinary Organs: is There Place for Secondary Cytoreductive Surgery?

Exenteração pélvica e preservação dos esfíncteres: análise de 96 casos

Pelvic exenteration for advanced pelvic malignancy

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