Quality of life and other patient-reported outcomes following exenteration for pelvic malignancy

Abstract

Quality of life and related patient-reported outcomes improve rapidly after pelvic exenteration surgery. For 9 months after surgery, these outcomes are comparable with those of similar do patients who do not have surgery; thereafter, there is a decline in patients who do not have exenteration. Pelvic exenteration can be performed with acceptable quality of life and patient-reported outcomes.

Critical evaluation of contemporary management in a new Pelvic Exenteration Unit: The first 25 consecutive cases

“…The postoperative complication rate in our case series was 48% but the actual serious morbidity (grades 3 and 4 Clavien-Dindo) was 12%, and two-third of the adverse events in our case series were grade 2 Clavien-Dindo that necessitated pharmacological treatment alone. This finding is comparable to the median rate of 57% that was reported from the systematic review[9]. Short-term follow-up in our case series found a recurrence rate of 28%.…”

“…In a systematic review, Heriot et al[6] reported exenteration-related morbidity and mortality rates of 27% and 0.6% respectively. Similar trends were found in an Australian study of 148 patients who underwent PE, which reported a 0% 30-d mortality rate and good postoperative quality of life[9]. …”

“…To assess our short experience using a multidisciplinary team approach for PE surgery, the outcomes of a series of 25 consecutive patients were evaluated based on morbidity, mortality and recurrence. A systematic review performed by Young et al[9], which incorporated 23 studies and 1049 patients as a benchmark, noted a 73% R0 resection rate (range: 42%-100%). In that same review, the median perioperative mortality rate was low, at 2.2%, with the majority ranging from 0% to 25%.…”

The Outcomes and Patterns of Treatment Failure After Surgery for Locally Recurrent Rectal Cancer

“…This has been established both cross-sectionally in the long-term survivors and looking prospectively at the trajectories longitudinally compared with those with isolated local recurrence who were offered palliative treatments only. 17,18 Cross-sectional quality of life studies in longterm survivors has demonstrated excellent scores and is comparable to the quality of life of a primary rectal cancer resection. 19 However, the quality of life trajectory postexenteration during the initial 6-to 12-month recovery period is lower than the normal population, but it is no worse than those offered palliation, and returns to preoperative levels by 3 to 6 months' postsurgery.…”

Preoperative exercise halves the postoperative complication rate in patients with lung cancer: a systematic review of the effect of exercise on complications, length of stay and quality of life in patients with cancer

“…There is evidence that preoperative quality of life in patients with cancer is poor and decreases even further after surgery 42. In addition, despite the evidence suggesting that exercise improves physical and mental health in patients with cancer,43 there are only a limited number of trials investigating the effect of preoperative exercise on patients’ quality of life.…”