title: Exenteration as a primary treatment for locally advanced cervical cancer: long-term results and prognostic factors.
abstract: OBJECTIVE
  Whereas pelvic exenteration is an established therapy for the treatment of recurrent cervical carcinoma, it is not often performed for primary locally advanced cervical cancer (LACC).
  
  
  METHODS
  This retrospective study analyzed survival data and prognostic factors of 35 patients with LACC who were treated by pelvic exenteration.
  
  
  RESULTS
  After surgery, 33 patients (97%) were macroscopically free of tumor. In 20 patients, pelvic lymph nodes (LN) were involved, and in 6 of these, metastatic tissue had reached the paraaortal nodes. Overall, the patients' mean 5 year survival was 43%, and the median survival time was 30 months; these values ranged from 15% to 70% and from 15 to 44 months, respectively, depending on LN involvement (P=.006). Pelvic LN involvement was the only significant factor for overall survival found in the multivariate analysis (P=.02).
  
  
  CONCLUSIONS
  In LACC with free LNs and no distant metastases, pelvic exenteration has good long-term results.
authors.affiliation: Department of Obstetrics and Gynecology, Florence Nightingale Hospital, Kaiserwerther Diakonie, Dusseldorf, Germany. dr.forner@gmx.de
authors.forename: Dirk Michael
authors.initials: DM
authors.lastname: Forner
authors.forename: Bjoern
authors.initials: B
authors.lastname: Lampe
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D016001:Confidence Intervals; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision / Q000379:methods; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology*; D009367:Neoplasm Staging; D010385:Pelvic Exenteration / Q000379:methods* / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*