Management of advanced pelvic cancer by exenteration.
OBJECTIVE
To describe our results in managing locally advanced primary or recurrent pelvic malignancies.


METHODS
Investigations included: clinical, laboratory, endoscopic (rectoscopy and colonoscopy) examinations, ultrasound scan, and CT scan or MRI of the abdomen and pelvis, to determine the extent of the pelvic malignancy. A careful explorative laparatomy of abdomen and pelvis was performed, followed by anterior, posterior or total pelvic exenteration.


RESULTS
In the period June 1995-Jan 2002, 7 anterior, 2 posterior and 51 total pelvic exenterations were performed in 60 patients, distributed as follows: 28 for rectal cancer (12 primary, 16 recurrent), 20 for cervical cancer (9 primary, 11 recurrent) and 12 for other pelvic malignancies. The median survival time and overall 5-year survival rates were as follows: primary rectal cancer--50 months and 32%; recurrent rectal cancer--31 months and 17%; primary cervical cancer--46.4 months and 41% and recurrent cervical cancer--23.4 months and 16%. During the same period, 559 of our patients were treated for primary or recurrent rectal cancer by different types of straightforward resection.


CONCLUSIONS
Pelvic exenteration is justifiable in cases of locally advanced primary and recurrent malignancies of rectum, cervical cancer and possibly in cases of other pelvic malignancies.
Kecmanovic
D M
DM
Department for Colorectal Surgery, Clinical Center of Serbia, First Surgical University Hospital, Koste Todorovica 6, 11000 Belgrade, Serbia and Montenegro, Yugoslavia. keca@sezampro.yu
Pavlov
M J
MJ
Kovacevic
P A
PA
Sepetkovski
A V
AV
Ceranic
M S
MS
Stamenkovic
A B
AB
D015179:Colorectal Neoplasms / Q000401:mortality / Q000601:surgery; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008279:Magnetic Resonance Imaging; D008297:Male; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D010166:Palliative Care; D010385:Pelvic Exenteration; D010386:Pelvic Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D015022:Yugoslavia