title: Prognostic factors in pelvic exenteration for gynecological malignancies.
abstract: OBJECTIVE
  Analyze morbidity, mortality and prognostic factors after pelvic exenteration (PE) for gynecological malignancies.
  
  
  METHODS
  We reviewed a series of 107 individuals who underwent PE at A.C. Camargo Cancer Hospital from August 1982 to September 2010.
  
  
  RESULTS
  Median age was 56.4 years. Primary tumor sites were uterine cervix in 73 cases (68.2%); vaginal, 10 (9.3%); endometrial, 14 (13.1%); vulvar, 7 (6.5%); and uterine sarcomas, 3 (2.8%). Median tumor size was 5.5 cm. Total PE was performed in 56 cases (52.3%), anterior in 31 (29.9%), posterior in 10 (9.3%) and lateral extended in 10. Median operation time, blood transfusion and hospital stay length were 420 min (range: 180-780), 900 ml (range: 300-4500) and 13 days (range: 4-79), respectively. There was no intra-operative death. Fifty-seven (53.3%) and 48 (44.8%) patients had early and late complications, respectively. Five-year progression free survival (PFS), overall survival (OS) and cancer specific survival (CSS) were 35.8%, 27.4% and 41.1%, respectively. Endometrial cancer had better 5-year OS (64.3%) than cervical cancer (23.1%). Lymph node metastasis negatively impacted PFS, CSS and OS. Presence of perineural invasion negatively impacted PFS and CSS. No variable retained the risk of recurrence or death in the multivariate analysis.
  
  
  CONCLUSIONS
  PE has acceptable morbidity and mortality and may be the only method that can offer long-term survival in highly selected patients.
authors: Department of Gynecologic Oncology, AC Camargo Cancer Hospital, Sao Paulo, Brazil. glbaiocchi@yahoo.com.br
authors: G
authors: G
authors: Baiocchi
authors: G C
authors: GC
authors: Guimaraes
authors: R A
authors: RA
authors: Rosa Oliveira
authors: L Y
authors: LY
authors: Kumagai
authors: C C
authors: CC
authors: Faloppa
authors: S
authors: S
authors: Aguiar
authors: M D
authors: MD
authors: Begnami
authors: F A
authors: FA
authors: Soares
authors: A
authors: A
authors: Lopes
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil; D015331:Cohort Studies; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D005833:Genital Neoplasms, Female / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007150:Immunohistochemistry; D015994:Incidence; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology*; D009367:Neoplasm Staging; D010385:Pelvic Exenteration / Q000379:methods / Q000401:mortality*; D010386:Pelvic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000401:mortality / Q000503:physiopathology; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome