The role of pelvic exenteration and reconstruction for treatment of advanced or recurrent gynecologic malignancies: Analysis of risk factors predicting recurrence and survival.
OBJECTIVE
Pelvic exenteration offers the last chance of cure for some advanced or recurrent gynecologic malignancy patients. The aim of this prospective study was to analyze factors associated with recurrence and survival after pelvic exenteration.


METHODS
Forty-six women with advanced or recurrent gynecologic malignancies were enrolled between July 2001 and February 2006. All pelvic exenteration surgery was performed by the same gynecological oncologist.


RESULTS
Two patients were excluded due to the discovery of peritoneal disease during surgery. Multivariate analysis showed that a tumor size >4 cm was the only factor associated with risk of recurrence after surgery (P = 0.014), that margin status was the only factor associated with disease-free survival (P = 0.0.047), and that margin status and lymph node metastasis were associated with overall survival (P = 0.017 and 0.012, respectively).


CONCLUSIONS
Pelvic exenteration and reconstruction was found to have a potential to provide long-term survival without postoperative mortality although the morbidity rate is somewhat high. Multivariate analysis showed that tumor size >4 cm was a predictive factor for recurrence, and that margin status and lymph node metastasis were predictive factors for survival.
Park
Jeong-Yeol
JY
Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, Korea. catgut1-0@hanmail.net
Choi
Hyuck Jae
HJ
Jeong
Seung-Yong
SY
Chung
Jinsoo
J
Park
Jung Kun
JK
Park
Sang-Yoon
SY
D000328:Adult; D000368:Aged; D005260:Female; D005833:Genital Neoplasms, Female / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology / Q000601:surgery*; D010385:Pelvic Exenteration; D011446:Prospective Studies; D019651:Plastic Surgery Procedures; D012307:Risk Factors