Pelvic exenteration: a perspective from a regional cancer center in India.
BACKGROUND
Pelvic exenteration is an extensive surgical procedure performed for locally advanced cancers in the pelvis.


OBJECTIVE
The twenty-year experience with this procedure at the Cancer Institute has been analyzed for morbidity, failure pattern and survival.


METHODS
The case records of all the patients who had undergone pelvic exenteration between 1981 and 2000 at Cancer Institute (WIA), Chennai were retrieved from Tumor Registry and were analyzed.


METHODS
Forty-eight patients underwent Pelvic Exenteration from 1981 to 2000 at the institute. Twenty-nine of them had rectal cancer, 15 had cervical cancer, 3 had bladder cancer, and 1 had ovarian cancer. There were 43 women and 5 men with a median age of 45 years.


METHODS
The survival rates were calculated by Kaplan-Meier method using EGRET statistical software package.


RESULTS
The operative mortality and postoperative morbidity were 10.42% and 62.50% respectively. The 5-year overall survival for the patients with Ca rectum and Ca cervix were 54.2% and 77.6% respectively. All 4 patients with Ca bladder or Ca ovary survived for more than 5 years. On multivariate analysis, nodal involvement and number of positive nodes emerged as significant prognostic factors for patients with Ca rectum. Although no factor reached statistical significance for patients with Ca cervix, those with adjacent organ invasion had a trend towards poorer survival.


CONCLUSIONS
For carefully selected locally advanced cancer in the pelvis, pelvic exenteration may provide the opportunity of long-term survival.
Department of Surgical Oncology, Cancer Institute (WIA), Chennai, India. durgatosh@yahoo.co.in.
Durgatosh
D
Pandey
Shuaib
S
Zaidi
Vikas
V
Mahajan
Ravi
R
Kannan
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000601:surgery*; D010385:Pelvic Exenteration; D012004:Rectal Neoplasms / Q000601:surgery*; D012042:Registries; D015996:Survival Rate; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D002583:Uterine Cervical Neoplasms / Q000601:surgery*