Pelvic exenteration for advanced nonrectal pelvic malignancy

M. E. Kelly; E. J. Ryan; A. G.J. Aalbers; Aziz N. Abdul; M. Abraham-Nordling; W. Alberda; A. Antoniou; K. K. Austin; R. Baker; M. Bali; G. Baseckas; B. K. Bednarski; G. L. Beets; P. L. Berg; J. Beynon; S. Biondo; L. Bordeianou; A. B. Bremers; M. Brunner; P. Buchwald; J. W.A. Burger; D. Burling; N. Campain; K. K.L. Chan; G. J. Chang; M. H. Chew; C. P. Chong; H. K. Christensen; M. Codd; A. J. Colquhoun; A. Corr; M. Coscia; P. E. Coyne; B. Creavin; L. Damjanovic; I. R. Daniels; M. Davies; R. J. Davies; J. H.W. Dewilt; Q. Denost; C. Deutsch; D. Dietz; S. Domingo; E. J. Dozois; M. Duff; T. Eglinton; M. D. Evans; N. S. Fearnhead; F. A. Frizelle; E. Garcia-Granero; J. L. Garcia-Sabrido; L. Gentilini; M. L. George; R. Glynn; T. Golda; B. Griffiths; D. A. Harris; M. Evans; J. A.W. Hagemans; D. P. Harji; A. G. Heriot; W. Hohenberger; T. Holm; E. Humphries; G. Jansson-Palmer; J. T. Jenkins; S. Kapur; Y. Kanemitsu; S. R. Kelley; D. S. Keller; H. Kim; C. E. Koh; N. F.M. Kok; R. Kokelaar; C. Kontovounisios; H. Kroon; M. Kusters; V. Lago; D. W. Larson; W. L. Law; S. Laurberg; P. Lee; M. L. Lydrup; A. C. Lynch; K. L. Mathis; A. Martling; W. J.H.J. Meijerink; S. Merkel; A. M. Mehta; F. D. McDermott; J. S. McGrath; A. Mihailo; A. Mirnezami; J. R. Morton; T. G. Mullaney; M. B. Nielsen; G. A.P. Nieuwenhuijzen; P. J. Nilsson; P. R. O'Connell; G. Palmer; D. Patsouras; G. Pellino; G. Poggioli; M. Quinn; A. Quyn; R. W. Radwan; S. Rasheed; P. C. Rasmussen; R. Rocha; J. Rothbarth; C. Roxburgh; H. J.T. Rutten; P. M. Sagar; T. Sammour; A. M.P. Schizas; E. Schwarzkopf; V. Scripcariu; I. Shaikh; D. Shida; A. Simpson; N. J. Smart; J. J. Smith; M. J. Solomon; M. M. Sørensen; S. R. Steele; D. Steffens; L. Stocchi; N. A. Stylianides; P. P. Tekkis; C. Taylor; S. Tsukamoto; W. H. Turner; J. B. Tuynman; G. H. Vanramshorst; Zoggel D. Van; W. Vasquez-Jimenez; C. Verhoef; C. Wakeman; S. Warrier; H. H. Wasmuth; M. R. Weiser; J. M.D. Wheeler; J. Wild; J. Yip; D. C. Winter

doi:10.1097/SLA.0000000000003533

Pelvic exenteration for advanced nonrectal pelvic malignancy

M. E. Kelly, E. J. Ryan, A. G.J. Aalbers, Aziz N. Abdul, M. Abraham-Nordling, W. Alberda, A. Antoniou, K. K. Austin, R. Baker, M. Bali, G. Baseckas, B. K. Bednarski, G. L. Beets, P. L. Berg, J. Beynon, S. Biondo, L. Bordeianou, A. B. Bremers, M. Brunner, P. BuchwaldJ. W.A. Burger, D. Burling, N. Campain, K. K.L. Chan, G. J. Chang, M. H. Chew, C. P. Chong, H. K. Christensen, M. Codd, A. J. Colquhoun, A. Corr, M. Coscia, P. E. Coyne, B. Creavin, L. Damjanovic, I. R. Daniels, M. Davies, R. J. Davies, J. H.W. Dewilt, Q. Denost, C. Deutsch, D. Dietz, S. Domingo, E. J. Dozois, M. Duff, T. Eglinton, M. D. Evans, N. S. Fearnhead, F. A. Frizelle, E. Garcia-Granero, J. L. Garcia-Sabrido, L. Gentilini, M. L. George, R. Glynn, T. Golda, B. Griffiths, D. A. Harris, M. Evans, J. A.W. Hagemans, D. P. Harji, A. G. Heriot, W. Hohenberger, T. Holm, E. Humphries, G. Jansson-Palmer, J. T. Jenkins, S. Kapur, Y. Kanemitsu, S. R. Kelley, D. S. Keller, H. Kim, C. E. Koh, N. F.M. Kok, R. Kokelaar, C. Kontovounisios, H. Kroon, M. Kusters, V. Lago, D. W. Larson, W. L. Law, S. Laurberg, P. Lee, M. L. Lydrup, A. C. Lynch, K. L. Mathis, A. Martling, W. J.H.J. Meijerink, S. Merkel, A. M. Mehta, F. D. McDermott, J. S. McGrath, A. Mihailo, A. Mirnezami, J. R. Morton, T. G. Mullaney, M. B. Nielsen, G. A.P. Nieuwenhuijzen, P. J. Nilsson, P. R. O'Connell, G. Palmer, D. Patsouras, G. Pellino, G. Poggioli, M. Quinn, A. Quyn, R. W. Radwan, S. Rasheed, P. C. Rasmussen, R. Rocha, J. Rothbarth, C. Roxburgh, H. J.T. Rutten, P. M. Sagar, T. Sammour, A. M.P. Schizas, E. Schwarzkopf, V. Scripcariu, I. Shaikh, D. Shida, A. Simpson, N. J. Smart, J. J. Smith, M. J. Solomon, M. M. Sørensen, S. R. Steele, D. Steffens, L. Stocchi, N. A. Stylianides, P. P. Tekkis, C. Taylor, S. Tsukamoto, W. H. Turner, J. B. Tuynman, G. H. Vanramshorst, Zoggel D. Van, W. Vasquez-Jimenez, C. Verhoef, C. Wakeman, S. Warrier, H. H. Wasmuth, M. R. Weiser, J. M.D. Wheeler, J. Wild, J. Yip, D. C. Winter

Colon and Rectal Surgery

Research output: Contribution to journal › Article › peer-review

Abstract

Objective: To determine factors associated with outcomes following pelvic exenteration for advanced nonrectal pelvic malignancy. Background: The PelvEx Collaborative provides large volume data from specialist centers to ascertain factors associated with improved outcomes. Methods: Consecutive patients who underwent pelvic exenteration for nonrectal pelvic malignancy between 2006 and 2017 were identified from 22 tertiary centers. Patient demographics, neoadjuvant therapy, histopathological assessment, length of stay, 30-day major complication/mortality rate were recorded. The primary endpoints were factors associated with survival. The secondary endpoints included the difference in margin rates across the cohorts, impact of neoadjuvant treatment on survival, associated morbidity, and mortality. Results: One thousand two hundred ninety-three patients were identified. 40.4% (n = 523) had gynecological malignancies (endometrial, ovarian, cervical, and vaginal), 35.7% (n = 462) urological (bladder), 18.1% (n = 234) anal, and 5.7% had sarcoma (n = 74). The median age across the cohort was 63 years (range, 23-85). The median 30-day mortality rate was 1.7%, with the highest rates occurring following exenteration for recurrent sarcoma or locally advanced cervical cancer (3.3% each). The median length of hospital stay was 17.5 days. 34.5% of patients experienced a major complication, with highest rate occurring in those having salvage surgery for anal cancer. Multivariable analysis showed R0 resection was the main factor associated with long-term survival. The 3-year overall-survival rate for R0 resection was 48% for endometrial malignancy, 40.6% for ovarian, 49.4% for cervical, 43.8% for vaginal, 59% for bladder, 48.3% for anal, and 48.1% for sarcoma. Conclusion: Pelvic exenteration remains an important treatment in selected patients with advanced or recurrent nonrectal pelvic malignancy. The range in 3-year overall survival following R0 resection (40%-59%) reflects the diversity of tumor types.

Original language	English (US)
Pages (from-to)	899-905
Number of pages	7
Journal	Annals of surgery
Volume	270
Issue number	5
DOIs	https://doi.org/10.1097/SLA.0000000000003533
State	Published - Nov 2019

Keywords

International collaboration
Pelvic exenteration
Pelvic malignancy
Surgical outcomes
Survival outcomes

ASJC Scopus subject areas

Surgery

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10.1097/SLA.0000000000003533

Cite this

Kelly, M. E., Ryan, E. J., Aalbers, A. G. J., Abdul, A. N., Abraham-Nordling, M., Alberda, W., Antoniou, A., Austin, K. K., Baker, R., Bali, M., Baseckas, G., Bednarski, B. K., Beets, G. L., Berg, P. L., Beynon, J., Biondo, S., Bordeianou, L., Bremers, A. B., Brunner, M., ... Winter, D. C. (2019). Pelvic exenteration for advanced nonrectal pelvic malignancy. Annals of surgery, 270(5), 899-905. https://doi.org/10.1097/SLA.0000000000003533

Kelly, ME, Ryan, EJ, Aalbers, AGJ, Abdul, AN, Abraham-Nordling, M, Alberda, W, Antoniou, A, Austin, KK, Baker, R, Bali, M, Baseckas, G, Bednarski, BK, Beets, GL, Berg, PL, Beynon, J, Biondo, S, Bordeianou, L, Bremers, AB, Brunner, M, Buchwald, P, Burger, JWA, Burling, D, Campain, N, Chan, KKL, Chang, GJ, Chew, MH, Chong, CP, Christensen, HK, Codd, M, Colquhoun, AJ, Corr, A, Coscia, M, Coyne, PE, Creavin, B, Damjanovic, L, Daniels, IR, Davies, M, Davies, RJ, Dewilt, JHW, Denost, Q, Deutsch, C, Dietz, D, Domingo, S, Dozois, EJ, Duff, M, Eglinton, T, Evans, MD, Fearnhead, NS, Frizelle, FA, Garcia-Granero, E, Garcia-Sabrido, JL, Gentilini, L, George, ML, Glynn, R, Golda, T, Griffiths, B, Harris, DA, Evans, M, Hagemans, JAW, Harji, DP, Heriot, AG, Hohenberger, W, Holm, T, Humphries, E, Jansson-Palmer, G, Jenkins, JT, Kapur, S, Kanemitsu, Y, Kelley, SR, Keller, DS, Kim, H, Koh, CE, Kok, NFM, Kokelaar, R, Kontovounisios, C, Kroon, H, Kusters, M, Lago, V, Larson, DW, Law, WL, Laurberg, S, Lee, P, Lydrup, ML, Lynch, AC, Mathis, KL, Martling, A, Meijerink, WJHJ, Merkel, S, Mehta, AM, McDermott, FD, McGrath, JS, Mihailo, A, Mirnezami, A, Morton, JR, Mullaney, TG, Nielsen, MB, Nieuwenhuijzen, GAP, Nilsson, PJ, O'Connell, PR, Palmer, G, Patsouras, D, Pellino, G, Poggioli, G, Quinn, M, Quyn, A, Radwan, RW, Rasheed, S, Rasmussen, PC, Rocha, R, Rothbarth, J, Roxburgh, C, Rutten, HJT, Sagar, PM, Sammour, T, Schizas, AMP, Schwarzkopf, E, Scripcariu, V, Shaikh, I, Shida, D, Simpson, A, Smart, NJ, Smith, JJ, Solomon, MJ, Sørensen, MM, Steele, SR, Steffens, D, Stocchi, L, Stylianides, NA, Tekkis, PP, Taylor, C, Tsukamoto, S, Turner, WH, Tuynman, JB, Vanramshorst, GH, Van, ZD, Vasquez-Jimenez, W, Verhoef, C, Wakeman, C, Warrier, S, Wasmuth, HH, Weiser, MR, Wheeler, JMD, Wild, J, Yip, J & Winter, DC 2019, 'Pelvic exenteration for advanced nonrectal pelvic malignancy', Annals of surgery, vol. 270, no. 5, pp. 899-905. https://doi.org/10.1097/SLA.0000000000003533

@article{588ea9abdb2b44dd8d47eb32834972ee,

title = "Pelvic exenteration for advanced nonrectal pelvic malignancy",

abstract = "Objective: To determine factors associated with outcomes following pelvic exenteration for advanced nonrectal pelvic malignancy. Background: The PelvEx Collaborative provides large volume data from specialist centers to ascertain factors associated with improved outcomes. Methods: Consecutive patients who underwent pelvic exenteration for nonrectal pelvic malignancy between 2006 and 2017 were identified from 22 tertiary centers. Patient demographics, neoadjuvant therapy, histopathological assessment, length of stay, 30-day major complication/mortality rate were recorded. The primary endpoints were factors associated with survival. The secondary endpoints included the difference in margin rates across the cohorts, impact of neoadjuvant treatment on survival, associated morbidity, and mortality. Results: One thousand two hundred ninety-three patients were identified. 40.4% (n = 523) had gynecological malignancies (endometrial, ovarian, cervical, and vaginal), 35.7% (n = 462) urological (bladder), 18.1% (n = 234) anal, and 5.7% had sarcoma (n = 74). The median age across the cohort was 63 years (range, 23-85). The median 30-day mortality rate was 1.7%, with the highest rates occurring following exenteration for recurrent sarcoma or locally advanced cervical cancer (3.3% each). The median length of hospital stay was 17.5 days. 34.5% of patients experienced a major complication, with highest rate occurring in those having salvage surgery for anal cancer. Multivariable analysis showed R0 resection was the main factor associated with long-term survival. The 3-year overall-survival rate for R0 resection was 48% for endometrial malignancy, 40.6% for ovarian, 49.4% for cervical, 43.8% for vaginal, 59% for bladder, 48.3% for anal, and 48.1% for sarcoma. Conclusion: Pelvic exenteration remains an important treatment in selected patients with advanced or recurrent nonrectal pelvic malignancy. The range in 3-year overall survival following R0 resection (40%-59%) reflects the diversity of tumor types.",

keywords = "International collaboration, Pelvic exenteration, Pelvic malignancy, Surgical outcomes, Survival outcomes",

author = "Kelly, {M. E.} and Ryan, {E. J.} and Aalbers, {A. G.J.} and Abdul, {Aziz N.} and M. Abraham-Nordling and W. Alberda and A. Antoniou and Austin, {K. K.} and R. Baker and M. Bali and G. Baseckas and Bednarski, {B. K.} and Beets, {G. L.} and Berg, {P. L.} and J. Beynon and S. Biondo and L. Bordeianou and Bremers, {A. B.} and M. Brunner and P. Buchwald and Burger, {J. W.A.} and D. Burling and N. Campain and Chan, {K. K.L.} and Chang, {G. J.} and Chew, {M. H.} and Chong, {C. P.} and Christensen, {H. K.} and M. Codd and Colquhoun, {A. J.} and A. Corr and M. Coscia and Coyne, {P. E.} and B. Creavin and L. Damjanovic and Daniels, {I. R.} and M. Davies and Davies, {R. J.} and Dewilt, {J. H.W.} and Q. Denost and C. Deutsch and D. Dietz and S. Domingo and Dozois, {E. J.} and M. Duff and T. Eglinton and Evans, {M. D.} and Fearnhead, {N. S.} and Frizelle, {F. A.} and E. Garcia-Granero and Garcia-Sabrido, {J. L.} and L. Gentilini and George, {M. L.} and R. Glynn and T. Golda and B. Griffiths and Harris, {D. A.} and M. Evans and Hagemans, {J. A.W.} and Harji, {D. P.} and Heriot, {A. G.} and W. Hohenberger and T. Holm and E. Humphries and G. Jansson-Palmer and Jenkins, {J. T.} and S. Kapur and Y. Kanemitsu and Kelley, {S. R.} and Keller, {D. S.} and H. Kim and Koh, {C. E.} and Kok, {N. F.M.} and R. Kokelaar and C. Kontovounisios and H. Kroon and M. Kusters and V. Lago and Larson, {D. W.} and Law, {W. L.} and S. Laurberg and P. Lee and Lydrup, {M. L.} and Lynch, {A. C.} and Mathis, {K. L.} and A. Martling and Meijerink, {W. J.H.J.} and S. Merkel and Mehta, {A. M.} and McDermott, {F. D.} and McGrath, {J. S.} and A. Mihailo and A. Mirnezami and Morton, {J. R.} and Mullaney, {T. G.} and Nielsen, {M. B.} and Nieuwenhuijzen, {G. A.P.} and Nilsson, {P. J.} and O'Connell, {P. R.} and G. Palmer and D. Patsouras and G. Pellino and G. Poggioli and M. Quinn and A. Quyn and Radwan, {R. W.} and S. Rasheed and Rasmussen, {P. C.} and R. Rocha and J. Rothbarth and C. Roxburgh and Rutten, {H. J.T.} and Sagar, {P. M.} and T. Sammour and Schizas, {A. M.P.} and E. Schwarzkopf and V. Scripcariu and I. Shaikh and D. Shida and A. Simpson and Smart, {N. J.} and Smith, {J. J.} and Solomon, {M. J.} and S{\o}rensen, {M. M.} and Steele, {S. R.} and D. Steffens and L. Stocchi and Stylianides, {N. A.} and Tekkis, {P. P.} and C. Taylor and S. Tsukamoto and Turner, {W. H.} and Tuynman, {J. B.} and Vanramshorst, {G. H.} and Van, {Zoggel D.} and W. Vasquez-Jimenez and C. Verhoef and C. Wakeman and S. Warrier and Wasmuth, {H. H.} and Weiser, {M. R.} and Wheeler, {J. M.D.} and J. Wild and J. Yip and Winter, {D. C.}",

year = "2019",

month = nov,

doi = "10.1097/SLA.0000000000003533",

language = "English (US)",

volume = "270",

pages = "899--905",

journal = "Annals of surgery",

issn = "0003-4932",

publisher = "Lippincott Williams and Wilkins",

number = "5",

}

TY - JOUR

T1 - Pelvic exenteration for advanced nonrectal pelvic malignancy

AU - Kelly, M. E.

AU - Ryan, E. J.

AU - Aalbers, A. G.J.

AU - Abdul, Aziz N.

AU - Abraham-Nordling, M.

AU - Alberda, W.

AU - Antoniou, A.

AU - Austin, K. K.

AU - Baker, R.

AU - Bali, M.

AU - Baseckas, G.

AU - Bednarski, B. K.

AU - Beets, G. L.

AU - Berg, P. L.

AU - Beynon, J.

AU - Biondo, S.

AU - Bordeianou, L.

AU - Bremers, A. B.

AU - Brunner, M.

AU - Buchwald, P.

AU - Burger, J. W.A.

AU - Burling, D.

AU - Campain, N.

AU - Chan, K. K.L.

AU - Chang, G. J.

AU - Chew, M. H.

AU - Chong, C. P.

AU - Christensen, H. K.

AU - Codd, M.

AU - Colquhoun, A. J.

AU - Corr, A.

AU - Coscia, M.

AU - Coyne, P. E.

AU - Creavin, B.

AU - Damjanovic, L.

AU - Daniels, I. R.

AU - Davies, M.

AU - Davies, R. J.

AU - Dewilt, J. H.W.

AU - Denost, Q.

AU - Deutsch, C.

AU - Dietz, D.

AU - Domingo, S.

AU - Dozois, E. J.

AU - Duff, M.

AU - Eglinton, T.

AU - Evans, M. D.

AU - Fearnhead, N. S.

AU - Frizelle, F. A.

AU - Garcia-Granero, E.

AU - Garcia-Sabrido, J. L.

AU - Gentilini, L.

AU - George, M. L.

AU - Glynn, R.

AU - Golda, T.

AU - Griffiths, B.

AU - Harris, D. A.

AU - Evans, M.

AU - Hagemans, J. A.W.

AU - Harji, D. P.

AU - Heriot, A. G.

AU - Hohenberger, W.

AU - Holm, T.

AU - Humphries, E.

AU - Jansson-Palmer, G.

AU - Jenkins, J. T.

AU - Kapur, S.

AU - Kanemitsu, Y.

AU - Kelley, S. R.

AU - Keller, D. S.

AU - Kim, H.

AU - Koh, C. E.

AU - Kok, N. F.M.

AU - Kokelaar, R.

AU - Kontovounisios, C.

AU - Kroon, H.

AU - Kusters, M.

AU - Lago, V.

AU - Larson, D. W.

AU - Law, W. L.

AU - Laurberg, S.

AU - Lee, P.

AU - Lydrup, M. L.

AU - Lynch, A. C.

AU - Mathis, K. L.

AU - Martling, A.

AU - Meijerink, W. J.H.J.

AU - Merkel, S.

AU - Mehta, A. M.

AU - McDermott, F. D.

AU - McGrath, J. S.

AU - Mihailo, A.

AU - Mirnezami, A.

AU - Morton, J. R.

AU - Mullaney, T. G.

AU - Nielsen, M. B.

AU - Nieuwenhuijzen, G. A.P.

AU - Nilsson, P. J.

AU - O'Connell, P. R.

AU - Palmer, G.

AU - Patsouras, D.

AU - Pellino, G.

AU - Poggioli, G.

AU - Quinn, M.

AU - Quyn, A.

AU - Radwan, R. W.

AU - Rasheed, S.

AU - Rasmussen, P. C.

AU - Rocha, R.

AU - Rothbarth, J.

AU - Roxburgh, C.

AU - Rutten, H. J.T.

AU - Sagar, P. M.

AU - Sammour, T.

AU - Schizas, A. M.P.

AU - Schwarzkopf, E.

AU - Scripcariu, V.

AU - Shaikh, I.

AU - Shida, D.

AU - Simpson, A.

AU - Smart, N. J.

AU - Smith, J. J.

AU - Solomon, M. J.

AU - Sørensen, M. M.

AU - Steele, S. R.

AU - Steffens, D.

AU - Stocchi, L.

AU - Stylianides, N. A.

AU - Tekkis, P. P.

AU - Taylor, C.

AU - Tsukamoto, S.

AU - Turner, W. H.

AU - Tuynman, J. B.

AU - Vanramshorst, G. H.

AU - Van, Zoggel D.

AU - Vasquez-Jimenez, W.

AU - Verhoef, C.

AU - Wakeman, C.

AU - Warrier, S.

AU - Wasmuth, H. H.

AU - Weiser, M. R.

AU - Wheeler, J. M.D.

AU - Wild, J.

AU - Yip, J.

AU - Winter, D. C.

PY - 2019/11

Y1 - 2019/11

N2 - Objective: To determine factors associated with outcomes following pelvic exenteration for advanced nonrectal pelvic malignancy. Background: The PelvEx Collaborative provides large volume data from specialist centers to ascertain factors associated with improved outcomes. Methods: Consecutive patients who underwent pelvic exenteration for nonrectal pelvic malignancy between 2006 and 2017 were identified from 22 tertiary centers. Patient demographics, neoadjuvant therapy, histopathological assessment, length of stay, 30-day major complication/mortality rate were recorded. The primary endpoints were factors associated with survival. The secondary endpoints included the difference in margin rates across the cohorts, impact of neoadjuvant treatment on survival, associated morbidity, and mortality. Results: One thousand two hundred ninety-three patients were identified. 40.4% (n = 523) had gynecological malignancies (endometrial, ovarian, cervical, and vaginal), 35.7% (n = 462) urological (bladder), 18.1% (n = 234) anal, and 5.7% had sarcoma (n = 74). The median age across the cohort was 63 years (range, 23-85). The median 30-day mortality rate was 1.7%, with the highest rates occurring following exenteration for recurrent sarcoma or locally advanced cervical cancer (3.3% each). The median length of hospital stay was 17.5 days. 34.5% of patients experienced a major complication, with highest rate occurring in those having salvage surgery for anal cancer. Multivariable analysis showed R0 resection was the main factor associated with long-term survival. The 3-year overall-survival rate for R0 resection was 48% for endometrial malignancy, 40.6% for ovarian, 49.4% for cervical, 43.8% for vaginal, 59% for bladder, 48.3% for anal, and 48.1% for sarcoma. Conclusion: Pelvic exenteration remains an important treatment in selected patients with advanced or recurrent nonrectal pelvic malignancy. The range in 3-year overall survival following R0 resection (40%-59%) reflects the diversity of tumor types.

AB - Objective: To determine factors associated with outcomes following pelvic exenteration for advanced nonrectal pelvic malignancy. Background: The PelvEx Collaborative provides large volume data from specialist centers to ascertain factors associated with improved outcomes. Methods: Consecutive patients who underwent pelvic exenteration for nonrectal pelvic malignancy between 2006 and 2017 were identified from 22 tertiary centers. Patient demographics, neoadjuvant therapy, histopathological assessment, length of stay, 30-day major complication/mortality rate were recorded. The primary endpoints were factors associated with survival. The secondary endpoints included the difference in margin rates across the cohorts, impact of neoadjuvant treatment on survival, associated morbidity, and mortality. Results: One thousand two hundred ninety-three patients were identified. 40.4% (n = 523) had gynecological malignancies (endometrial, ovarian, cervical, and vaginal), 35.7% (n = 462) urological (bladder), 18.1% (n = 234) anal, and 5.7% had sarcoma (n = 74). The median age across the cohort was 63 years (range, 23-85). The median 30-day mortality rate was 1.7%, with the highest rates occurring following exenteration for recurrent sarcoma or locally advanced cervical cancer (3.3% each). The median length of hospital stay was 17.5 days. 34.5% of patients experienced a major complication, with highest rate occurring in those having salvage surgery for anal cancer. Multivariable analysis showed R0 resection was the main factor associated with long-term survival. The 3-year overall-survival rate for R0 resection was 48% for endometrial malignancy, 40.6% for ovarian, 49.4% for cervical, 43.8% for vaginal, 59% for bladder, 48.3% for anal, and 48.1% for sarcoma. Conclusion: Pelvic exenteration remains an important treatment in selected patients with advanced or recurrent nonrectal pelvic malignancy. The range in 3-year overall survival following R0 resection (40%-59%) reflects the diversity of tumor types.

KW - International collaboration

KW - Pelvic exenteration

KW - Pelvic malignancy

KW - Surgical outcomes

KW - Survival outcomes

UR - http://www.scopus.com/inward/record.url?scp=85073656722&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85073656722&partnerID=8YFLogxK

U2 - 10.1097/SLA.0000000000003533

DO - 10.1097/SLA.0000000000003533

M3 - Article

C2 - 31634184

AN - SCOPUS:85073656722

SN - 0003-4932

VL - 270

SP - 899

EP - 905

JO - Annals of surgery

JF - Annals of surgery

IS - 5

ER -

Pelvic exenteration for advanced nonrectal pelvic malignancy

Abstract

Keywords

ASJC Scopus subject areas

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