Header

UZH-Logo

Maintenance Infos

Pelvic Exenteration for Primary Advanced and Recurrent Vaginal Cancer: Clinical Outcome for 37 Patients


Kimmich, Nina; Egger, Herwig; Schneider, Sasa; Schmidt, Ana-Maria (2020). Pelvic Exenteration for Primary Advanced and Recurrent Vaginal Cancer: Clinical Outcome for 37 Patients. Journal of Gynecologic Surgery, 36(5):244-249.

Abstract

Objective: To analyze the clinical outcome of patients after pelvic exenteration for advanced primary or recurrent vaginal cancer.

Design: Retrospective cohort study.

Materials and Methods: We analyzed the outcome of 37 patients after pelvic exenteration for advanced primary or recurrent vaginal cancer.

Results: The most common histologic type was the squamous cell carcinoma (78%). In total 86% of cases were stage III/IV carcinomas with a cancer grade of 3 in 65% of cases. Totally, 46% of cases were primary, 54% were secondary exenterations. We performed a total exenteration in 72%, an anterior or posterior in 14% each. A total of 76% of exenterations had a curative intention. R0 resection was achieved in 86% of cases. No major peri- or postoperative complications were found in 46% of patients. Death occurred in three patients (8%), all of them elderly and with comorbidities. Five- and 10-year overall survival rates ranged from 45.3% to even 88.9% in the best subgroup. Survival rates strongly depended on the type and intention of exenteration. The best survival rates were found in younger women with a primary exenteration in a curative intent and with metastasis-free lymph nodes.

Conclusion: Pelvic exenteration is a valid treatment option in advanced or recurrent vaginal cancer with low procedural mortality and good long-term survival rates in selected patients. Even in a palliative setting, 12.6% of patients survived long term. However, complication rates are still high and need to be intensively discussed with patients. In addition, long-term follow-up and attendance are strongly recommended to support patients in such a situation.

Abstract

Objective: To analyze the clinical outcome of patients after pelvic exenteration for advanced primary or recurrent vaginal cancer.

Design: Retrospective cohort study.

Materials and Methods: We analyzed the outcome of 37 patients after pelvic exenteration for advanced primary or recurrent vaginal cancer.

Results: The most common histologic type was the squamous cell carcinoma (78%). In total 86% of cases were stage III/IV carcinomas with a cancer grade of 3 in 65% of cases. Totally, 46% of cases were primary, 54% were secondary exenterations. We performed a total exenteration in 72%, an anterior or posterior in 14% each. A total of 76% of exenterations had a curative intention. R0 resection was achieved in 86% of cases. No major peri- or postoperative complications were found in 46% of patients. Death occurred in three patients (8%), all of them elderly and with comorbidities. Five- and 10-year overall survival rates ranged from 45.3% to even 88.9% in the best subgroup. Survival rates strongly depended on the type and intention of exenteration. The best survival rates were found in younger women with a primary exenteration in a curative intent and with metastasis-free lymph nodes.

Conclusion: Pelvic exenteration is a valid treatment option in advanced or recurrent vaginal cancer with low procedural mortality and good long-term survival rates in selected patients. Even in a palliative setting, 12.6% of patients survived long term. However, complication rates are still high and need to be intensively discussed with patients. In addition, long-term follow-up and attendance are strongly recommended to support patients in such a situation.

Statistics

Citations

Altmetrics

Downloads

1 download since deposited on 10 Dec 2020
1 download since 12 months
Detailed statistics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Obstetrics
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Surgery
Health Sciences > Obstetrics and Gynecology
Uncontrolled Keywords:Obstetrics and Gynaecology, Surgery
Language:English
Date:1 October 2020
Deposited On:10 Dec 2020 13:50
Last Modified:11 Dec 2020 21:01
Publisher:Mary Ann Liebert
ISSN:1042-4067
OA Status:Closed
Publisher DOI:https://doi.org/10.1089/gyn.2019.0145

Download

Closed Access: Download allowed only for UZH members