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Pelvic exenteration for colorectal and non-colorectal cancer: a comparison of perioperative and oncological outcome
BACKGROUND: Pelvic exenteration (PE) is the only option for long-term cure of advanced cancer originating from different types of tumor or recurrent disease in the lower pelvis. The aim was to show differences between colorectal and non-colorectal cancer in survival and postoperative morbidity. METH...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8279979/ https://www.ncbi.nlm.nih.gov/pubmed/33677655 http://dx.doi.org/10.1007/s00384-021-03893-y |
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author | Bogner, Andreas Fritzmann, Johannes Müssle, Benjamin Huber, Johannes Dobroschke, Jakob Bork, Ulrich Wolk, Steffen Distler, Marius Weitz, Jürgen Welsch, Thilo Kahlert, Christoph |
author_facet | Bogner, Andreas Fritzmann, Johannes Müssle, Benjamin Huber, Johannes Dobroschke, Jakob Bork, Ulrich Wolk, Steffen Distler, Marius Weitz, Jürgen Welsch, Thilo Kahlert, Christoph |
author_sort | Bogner, Andreas |
collection | PubMed |
description | BACKGROUND: Pelvic exenteration (PE) is the only option for long-term cure of advanced cancer originating from different types of tumor or recurrent disease in the lower pelvis. The aim was to show differences between colorectal and non-colorectal cancer in survival and postoperative morbidity. METHODS: Retrospective data of 63 patients treated with total pelvic exenteration between 2013 and 2018 are reported. Pre-, intra-, and postoperative parameters, survival data, and risk factors for complications were analyzed. RESULTS: A total of 57.2% (n = 37) of the patients had colorectal cancer, 22.3% had gynecological malignancies (vulvar (n = 6) or cervical (n = 8) cancer), 11.1% (n = 7) had anal cancer, and 9.5% had other primary tumors. A total of 30.2% (n = 19) underwent PE for a primary tumor and 69.8% (n = 44) for recurrent cancer. The 30-day in-hospital mortality was 0%. Neoadjuvant treatment was administered to 65.1% (n = 41) of the patients and correlated significantly with postoperative complications (odds ratio 4.441; 95% CI: 1.375–14.342, P > 0.05). R0, R1, R2, and Rx resections were achieved in 65.1%, 19%, 1.6%, and 14.3% of the patients, respectively. In patients undergoing R0 resection, 2-year OS and RFS were 73.2% and 52.4%, respectively. Resection status was a significant risk factor for recurrence-free and overall survival (OS) in univariate analysis. Multivariate analysis revealed age (P = 0.021), ASA ≥ 3 (P = 0.005), high blood loss (P = 0.028), low preoperative hemoglobin level (P < 0.001), nodal positivity (P < 0.001), and surgical complications (P = 0.003) as independent risk factors for OS. CONCLUSION: Pelvic exenteration is a procedure with high morbidity rates but remains the only curative option for advanced or recurrent colorectal and non-colorectal cancer in the pelvis. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00384-021-03893-y. |
format | Online Article Text |
id | pubmed-8279979 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-82799792021-07-20 Pelvic exenteration for colorectal and non-colorectal cancer: a comparison of perioperative and oncological outcome Bogner, Andreas Fritzmann, Johannes Müssle, Benjamin Huber, Johannes Dobroschke, Jakob Bork, Ulrich Wolk, Steffen Distler, Marius Weitz, Jürgen Welsch, Thilo Kahlert, Christoph Int J Colorectal Dis Original Article BACKGROUND: Pelvic exenteration (PE) is the only option for long-term cure of advanced cancer originating from different types of tumor or recurrent disease in the lower pelvis. The aim was to show differences between colorectal and non-colorectal cancer in survival and postoperative morbidity. METHODS: Retrospective data of 63 patients treated with total pelvic exenteration between 2013 and 2018 are reported. Pre-, intra-, and postoperative parameters, survival data, and risk factors for complications were analyzed. RESULTS: A total of 57.2% (n = 37) of the patients had colorectal cancer, 22.3% had gynecological malignancies (vulvar (n = 6) or cervical (n = 8) cancer), 11.1% (n = 7) had anal cancer, and 9.5% had other primary tumors. A total of 30.2% (n = 19) underwent PE for a primary tumor and 69.8% (n = 44) for recurrent cancer. The 30-day in-hospital mortality was 0%. Neoadjuvant treatment was administered to 65.1% (n = 41) of the patients and correlated significantly with postoperative complications (odds ratio 4.441; 95% CI: 1.375–14.342, P > 0.05). R0, R1, R2, and Rx resections were achieved in 65.1%, 19%, 1.6%, and 14.3% of the patients, respectively. In patients undergoing R0 resection, 2-year OS and RFS were 73.2% and 52.4%, respectively. Resection status was a significant risk factor for recurrence-free and overall survival (OS) in univariate analysis. Multivariate analysis revealed age (P = 0.021), ASA ≥ 3 (P = 0.005), high blood loss (P = 0.028), low preoperative hemoglobin level (P < 0.001), nodal positivity (P < 0.001), and surgical complications (P = 0.003) as independent risk factors for OS. CONCLUSION: Pelvic exenteration is a procedure with high morbidity rates but remains the only curative option for advanced or recurrent colorectal and non-colorectal cancer in the pelvis. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00384-021-03893-y. Springer Berlin Heidelberg 2021-03-07 2021 /pmc/articles/PMC8279979/ /pubmed/33677655 http://dx.doi.org/10.1007/s00384-021-03893-y Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Bogner, Andreas Fritzmann, Johannes Müssle, Benjamin Huber, Johannes Dobroschke, Jakob Bork, Ulrich Wolk, Steffen Distler, Marius Weitz, Jürgen Welsch, Thilo Kahlert, Christoph Pelvic exenteration for colorectal and non-colorectal cancer: a comparison of perioperative and oncological outcome |
title | Pelvic exenteration for colorectal and non-colorectal cancer: a comparison of perioperative and oncological outcome |
title_full | Pelvic exenteration for colorectal and non-colorectal cancer: a comparison of perioperative and oncological outcome |
title_fullStr | Pelvic exenteration for colorectal and non-colorectal cancer: a comparison of perioperative and oncological outcome |
title_full_unstemmed | Pelvic exenteration for colorectal and non-colorectal cancer: a comparison of perioperative and oncological outcome |
title_short | Pelvic exenteration for colorectal and non-colorectal cancer: a comparison of perioperative and oncological outcome |
title_sort | pelvic exenteration for colorectal and non-colorectal cancer: a comparison of perioperative and oncological outcome |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8279979/ https://www.ncbi.nlm.nih.gov/pubmed/33677655 http://dx.doi.org/10.1007/s00384-021-03893-y |
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