title: Indications, techniques and outcomes for pelvic exenteration in gynecological malignancy.
abstract: OBJECTIVE
  To review recently published literature presenting an overview of the current insights and (clinical and technical) developments on pelvic exenterative surgery for gynecological malignancies.
  
  
  RESULTS
  Lateral recurrences, positive pelvic node status, age and high body mass index should be abandoned as contraindications for pelvic exenteration. F-fluorodeoxyglucose positron emission tomography-computed tomography is a valuable imaging tool, especially for the detection of enlarged lymph nodes and for distinguishing fibrosis from recurrence. Combined omental plus vertical rectus abdominis myocutaenous flaps give significant reduction in complications, whereas fascia sparing (myo)cutaneous flaps seem promising in decreasing donor-site complications.
  
  
  CONCLUSIONS
  Pelvic exenteration is indicated when curative alternatives are inferior or exhausted for advanced primary or locally gynecological recurrent cancer confined to the pelvis. Palliative pelvic exenteration should only be considered when disease-related morbidity is uncontrollable with other therapeutic modalities. Modifications in different surgical steps are still evolving to decrease the pelvic exenteration associated high morbidity. A complete resection and lymph node invasion free status are directly related to a better prognosis.
authors: aDivision of Gynaecologic Oncology, Department of Gynaecology and Obstetrics bDepartments of Urology cAbdominal Surgery, Leuven Cancer Institute, European Union, KU Leuven, Leuven, Belgium.
authors: Manpreet
authors: M
authors: Kaur
authors: Steven
authors: S
authors: Joniau
authors: André
authors: A
authors: D'Hoore
authors: Ignace
authors: I
authors: Vergote
mesh_terms: D005260:Female; D019788:Fluorodeoxyglucose F18; D005833:Genital Neoplasms, Female / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D010385:Pelvic Exenteration; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D019788:Fluorodeoxyglucose F18