Pelvic exenteration for recurrent gynecologic malignancy: Survival and morbidity analysis of the 45-year experience at UCLA

Berek, Jonathan S.; Howe, Candace; Lagasse, Leo D.; Hacker, Neville F.

doi:10.1016/j.ygyno.2005.05.034

Cited by 237 publications

(194 citation statements)

References 23 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%

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%

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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“…87 Five-year survival rates after pelvic exenteration are 20 to 45%. [87][88][89] RT is more commonly offered to isolated vaginal or pelvic recurrence, with surgery reserved for RT failures in women who are with comorbidities, such as obesity, diabetes and hypertension. Five-year survival rates are 50%.…”

Section: Treatment Of Recurrent Diseasementioning

confidence: 99%

Cancer Endometrium: An Update

Kumar¹,

Goel²

2012

Journal of South Asian Federation of Obstetrics and Gynaecology

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Endometrial cancer is the most common gynecological cancer in developed countries and second most common in developing countries. Its incidence is increasing in postmenopausal women. Factors related to chronic estrogen exposure are associated with a higher incidence. Abnormal uterine bleeding is the cardinal symptom. All women with suspected endometrial cancer require transvaginal ultrasonography and most will undergo endometrial biopsy; more sophisticated radiological examinations are required for preoperative staging. The general approach for treatment of endometrial cancer is hysterectomy, bilateral salpingo-oophorectomy, abdominopelvic washings, lymph node evaluation and maximal surgical cytoreduction for those with advanced disease. Postoperative adjuvant therapy [vaginal brachytherapy, external beam radiation therapy (RT), chemotherapy] may be recommended depending on the estimated risk of recurrence. Individual patient characteristics and surgical as well as pathologic staging are the main factors that are used for postsurgical risk stratification, which in turn, directs the selection of adjuvant treatment.

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“…Eine ähnliche Altersverteilung eruierten in ihren Auswertungen Kolbert (60 Jahre (28 -87 Jahre)), Hafner (60 Jahre (19 -83)), Pinelo (55,7 Jahre), Fleisch (55 Jahre (22 -77 Jahre)), Morley (53 Jahre (21 -74 Jahre)) und Crozier (47 Jahre (22 -70 Jahre)) (Crozier et al, 1995;Kolbert et al, 1997;Morley et al, 1989;Hafner et al, 1992;Pinelo et al, 2006;Fleisch et al, 2007). In der Studie von Berek reichte das Altersspektrum von 26 bis 74 Jahren (Berek et al, 2005). In der Arbeit von Durgatosh lag das Durchschnittsalter bei 45 Jahren (Durgatosh et al, 2004).…”

Section: Altersverteilungunclassified

“…Der Anteil der Zervixkarzinome liegt bei 13 -97%, der der Vulvakarzinome bei 1 -61%, der der Korpuskarzinome bei 2-13%, der der Vaginalkarzinome bei 2 -14%, der der Ovarialkarzinome und der der Sarkome bei 1 -8% (Brunschwig, 1959;Kiselow, 1967;Rodriguez-Bigas et al, 1996;Aleksic et al, 1998;Houvenaeghel et al, 2004;Durgatosh et al, 2004;Berek et al, 2005;Lambrou et al, 2005;Morley et al, 1989;Goldberg et al, 2006;Wydra et al, 2006;Pinelo et al, 2006;Mourton et al, 2006;Fleisch et al, 2007). Die meisten Autoren sehen allerdings ein lokal fortgeschrittenes oder ein rezidivierendes Zervixkarzinom, welches sich durch ein vorzugsweise lokales Wachstum und erst spätere Fernmetastasierung ausgezeichnet, als die häufigste Indikation zur Exenteration (Brunschwig, 1960;Kiselow, 1967;Di Saia et al, 1973;Rodriguez-Bigas et al, 1996;Petri, 2001;Hillemans et al, 2004;Lambrou et al, 2005).…”

Section: Indikationunclassified

Behandlungsergebnisse der exenterativen Eingriffe bei gynäkologischen Malignomen an der Frauenklinik im Klinikum Kassel

Bogdanova¹

2008

Geburtsh Frauenheilk

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Pelvic exenteration for recurrent gynecologic malignancy: Survival and morbidity analysis of the 45-year experience at UCLA

Cited by 237 publications

References 23 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?

Cancer Endometrium: An Update

Behandlungsergebnisse der exenterativen Eingriffe bei gynäkologischen Malignomen an der Frauenklinik im Klinikum Kassel

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