title: Clinical outcomes of pelvic exenteration for locally advanced primary or recurrent non-colorectal pelvic malignancies.
abstract: OBJECTIVE
  The aim of this study was to evaluate the outcomes of patients who underwent extensive pelvic surgery for locally advanced primary or recurrent non-colorectal pelvic malignancies.
  
  
  METHODS
  We performed a retrospective review of the medical records of 19 patients with non-colorectal pelvic malignancies who underwent extensive surgery at our institution between January 2005 and May 2013. Overall survival and progression-free survival were estimated using the Kaplan-Meier method and compared using the logrank test.
  
  
  RESULTS
  With regard to tumor histology, 6 patients (31.6%) had gynecological tumors, 8( 42.1%) had urological tumors, 2( 10.5%) had sarcomas, and 3( 15.8%) had other malignancies. Total pelvic exenteration was performed in 13 patients (68.4%), and other procedures were performed in 6 patients( 31.6%). For all patients, the median operation time and blood loss were 699 min and 2,930 mL, respectively. Complete tumor resection( R0) was achieved in 13 patients( 68.4%), and 16 patients had complications( 84.2%). The median overall survival was 18.5 months for patients who underwent R0 resection, compared with 7.3 months for those who underwent R1/R2 surgery (p=0.113), and the median progression-free survival was 7.3 months for cases of R0 resection, compared with 2.0 months for cases of R1/R2 surgery (p=0.035).
  
  
  CONCLUSIONS
  Our findings indicate that extensive pelvic surgery may be an optimal treatment for some patients with locally advanced primary or recurrent non-colorectal pelvic malignancies. Careful patient selection according to oncological, anatomical, and patient-related factors may improve the outcomes of patients undergoing this extensive, aggressive pelvic surgical procedure.
authors.affiliation: Dept. of Surgery, Nara Medical University.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ueda
authors.forename: Fumikazu
authors.initials: F
authors.lastname: Koyama
authors.forename: Tadashi
authors.initials: T
authors.lastname: Nakagawa
authors.forename: Shinji
authors.initials: S
authors.lastname: Nakamura
authors.forename: Naoto
authors.initials: N
authors.lastname: Nishigori
authors.forename: Takashi
authors.initials: T
authors.lastname: Inoue
authors.forename: Keijiro
authors.initials: K
authors.lastname: Kawasaki
authors.forename: Shinsaku
authors.initials: S
authors.lastname: Obara
authors.forename: Takayuki
authors.initials: T
authors.lastname: Nakamoto
authors.forename: Hisao
authors.initials: H
authors.lastname: Fujii
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Nakajima
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010385:Pelvic Exenteration / Q000009:adverse effects; D010386:Pelvic Neoplasms / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult