title: [Curative pelvic exenteration for recurrent cervical carcinoma in the era of concurrent chemotherapy and radiation therapy. A systematic review].
abstract: OBJECTIVE
  The purpose of this review is to assess the preoperative management in case of recurrent cervical cancer, to assess patients for a surgical curative treatment.
  
  
  METHODS
  English publications were searched using PubMed and Cochrane Library.
  
  
  RESULTS
  In the purpose of curative surgery, pelvic exenteration required clear margins. Today, only half of pelvic exenteration procedures showed postoperative clear margins. Modern imaging (RMI and Pet-CT) does not allow defining local extension of microcopic disease, and thus postoperative clear margins. Despite the same generic term of pelvic exenteration, there is a wide heterogeneity in surgical procedures in published cohorts.
  
  
  CONCLUSIONS
  Because clear margins are required for curative pelvic exenteration, but are not predictable by preoperative assessment. The larger surgery, i.e. the infra-elevator exenteration with vulvectomy, could be the logical surgical choice to increase the rate of clear margins and therefore, recurrent cervical carcinoma patient survival.
authors.affiliation: Gynecology Department, Tertiary Surgery Center, Teaching Hospital of Rennes, hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, 35000 Rennes, France; Faculty of Medicine, université de Rennes 1, 2, rue Henry-Guilloux, 35000 Rennes, France. Electronic address: hugo.sardain@gmail.com.
authors.forename: H
authors.initials: H
authors.lastname: Sardain
authors.affiliation: Gynecology Department, Tertiary Surgery Center, Teaching Hospital of Rennes, hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, 35000 Rennes, France.
authors.forename: V
authors.initials: V
authors.lastname: Lavoué
authors.affiliation: Gynecology Department, Tertiary Surgery Center, Teaching Hospital of Rennes, hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, 35000 Rennes, France.
authors.forename: F
authors.initials: F
authors.lastname: Foucher
authors.affiliation: Gynecology Department, Tertiary Surgery Center, Teaching Hospital of Rennes, hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, 35000 Rennes, France; Faculty of Medicine, université de Rennes 1, 2, rue Henry-Guilloux, 35000 Rennes, France.
authors.forename: J
authors.initials: J
authors.lastname: Levêque
mesh_terms: D002277:Carcinoma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D005260:Female; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D010385:Pelvic Exenteration / Q000592:standards*; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*
keywords: Cancer du col de l’utérus; Cervical carcinoma; Exentération pelvienne; Pelvic exenteration; Recurrence; Récurrence