THE ROLE OF PELVIC EXENTERATION IN TREATING GYNECOLOGIC MALIGNANCIES
Keywords:
pelvectomy, pelvic exenteration, cervical cancer, bladder cancer, vaginal cancer, pelvic reconstructive surgery
Abstract
Pelvic exenteration is a radical surgical procedure, with curative potential, which is mainly carried out in cases with cancer of the bladder or the reproductive organs. Pelvectomy was initially carried out as a palliative surgical procedure but recently the aim of performing pelvic exenteration has shifted towards a curative role. Pelvectomy is a mutilating procedure and it is no longer acceptable to perform pelvic exenteration for the purpose of palliative care. Based on the fact that pelvectomy is a mutilating and extremely difficult surgical procedure the purpose of the present work is to assist in performing a rigurous selection of the patients undergoing pelvic exenteration. This work covers the indications and contraindications of performing pelvectomy and the surgical steps will be summarized in order to better understand both it’s benefits and drawbacks.
References
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[31] Wang, C.-J., Lai, C.-H., Huang, H.-J., Hong, J.-H., Chou, H.-H., Huang, K.-G., & Lin, J.-D. (1999). Recurrent cervical carcinoma after primary radical surgery. American Journal of Obstetrics and Gynecology,181(3), 518–524.
[32] Park, J.-Y., Choi, H. J., Jeong, S.-Y., Chung, J., Park, J. K., & Park, S.-Y. (2007). The role of pelvic exenteration and reconstruction for treatment of advanced or recurrent gynecologic malignancies: Analysis of risk factors predicting recurrence and survival. Journal of Surgical Oncology, 96(7), 560–568.
[33] (2019). Pelvic Exenteration for Advanced Nonrectal Pelvic Malignancy. Annals of Surgery, 270(5),899–905.
[34] Romeo, A., Gonzalez, M. I., Jaunarena, J., Zubieta, M. E., Favre, G., & Tejerizo, J. C. (2018). Exenteración pélvica para neoplasias ginecológicas: Complicaciones postoperatorias y resultados oncológicos. Actas Urológicas Españolas, 42(2), 121–125.
[35] Goldberg, G. L., Sukumvanich, P., Einstein, M. H., Smith, H. O., Anderson, P. S., & Fields, A. L. (2006). Total pelvic exenteration: The Albert Einstein College of Medicine/Montefiore Medical Center Experience (1987 to 2003).Gynecologic Oncology, 101(2), 261–268.
[2] Brunschwig A (1948) Complete excision of the pelvic viscera for advanced carcinoma.Cancer 1:177–183.
[3] Khoury-Collado F, Einstein MH, Bochner BH et al (2012) Pelvic exenteration with curative intent for recurrent uterine malignan-cies. Gynecologic Oncology, 124(1):42-47.
[4] Kaur, M., Joniau, S., D’Hoore, A., & Vergote, I. (2014). Indications, techniques and outcomes for pelvic exenteration in gynecological malignancy. Current Opinion in Oncology, 26(5),514–520.
[5] Nelson Teng, MD, PhD Pelvic Exenteration [emedicine.medscape.com/article/ 1833913-overview#a1].
[6] NCCN Clinical Practice Guidelines in Oncology, Cervical Cancer Version 5. 2019 -September 16, 2019.
[7] Cervical cancer: ESMO Clinical Practice Guidelinesfor diagnosis, treatment and follow-up, Annals of Oncology 28 (Supplement 4): iv72–iv83,2017.
[8] De Gregorio, N., de Gregorio, A., Ebner, F., Friedl, T. W. P., Huober, J., Hefty, R., Widschwendter, P. (2019). Pelvic exenteration as ultimate ratio for gynecologic cancers: single-center analyses of 37 cases. Archives of Gynecology and Obstetrics.
[9] Höckel M, Dornhöfer N (2006) Pelvic exenteration for gynae-cological tumours: achievements and unanswered questions. Lancet Oncol.7(10):837847.
[10] Roos EJ, Van Eijkeren MA, Boon TA, Heintz AP (2005) Pelvic exenteration as treatment of recurrent or advanced gynecologic and urologic cancer. Int JGynecolCancer.15(4):624–629.
[11] Benn, T., Brooks, R. A., Zhang, Q., Powell, M. A., Thaker, P. H., Mutch, D. G., & Zighelboim, I. (2011). Pelvic exenteration in gynecologic oncology: A single institution study over 20 years. Gynecologic Oncology,122(1),14–18.
[12] Tarek Bardawil, MD,Warner K Huh,MD – Vaginalcancer.www.emedicine. medscape.com/article/269188-overview.
[13] David Steinberg, MD - Bladder Cancer – [www.emedicine.medscape.com/ article/438262-overview].
[14] Barbara L. Hoffman, John O. Schorge, Karen D. Bradshaw, Lisa M. Halvorson, Joseph I. Schaffer, Marlene M. Corton - Williams Gynecology, Third Edition.
[15] Marnitz, S., Köhler, C., Müller, M., Behrens, K., Hasenbein, K., & Schneider, A. (2006). Indications for primary and secondary exenterations in patients with cervical cancer. Gynecologic Oncology, 103(3), 1023–1030.
[16] Sharma, S., OdunsI, K., Driscoll, D., & Lele, S. (2005). Pelvic exenterations for gynecological malignancies: twenty-year experience at Roswell Park Cancer Institute.International Journalof Gynecological Cancer, 15(3),475–482.
[17] Sevin BU,Koechli OR.Pelvic exenteration. Surg Clin North Am 2001;81(4):771–9.
[18] Ferron G, et al. [Pelvic exenteration: current state and pers-pectives].Gynecol ObstetFertil 2012;40:43-7.
[19] Beemer W, Hopkins MP, Morley GW. Vaginal reconstruction in gynecologic oncology.Obstet Gynecol 1988;72:911-4.
[20] Hage JJ, et al. Unfavorable long-term results of rectosigmoid neocolpopoiesis.Plast Reconstr Surg 1995;95:842—8 [discus-sion 849-50].
[21] McCraw JB, et al. Vaginal reconstruction with gracilis myocu-taneous flaps. Plast Reconstr Surg 1976;58:176-83.
[22] Lacey CG, et al. Vaginal reconstruction after exenteration with use of gracilis myocutaneous flaps: the University of California, San Francisco experience. Am J Obstet Gynecol 1988;158:1278-84.
[23] Sardain, H., Lavoué, V., Foucher, F., & Levêque, J. (2016). L’exentération pelvienne curative en cas de récurrence d’un cancer du col de l’utérus à l’ère de la radio-chimiothérapie concomitante : revue de la littérature. Journal de Gynécologie Obstétrique et Biologie de La Reproduction, 45(4), 315-329.
[24] Angioli, R., Panici, P. B., Mirhashemi, R., Mendez, L., Cantuaria, G., Basile, S., & Penalver, M. (2003). Continent urinary diversion and low colorectal anastomosis after pelvic exenteration. Quality of life and complication risk. Critical Reviews in Oncology/Hematology, 48(3), 281-285.
[25] Lambrou, N. C., Pearson, J. M., & Averette, H. E. (2005). Pelvic Exenteration of Gynecologic Malignancy: Indications, and Technical and Reconstructive Considerations. Surgical Oncology Clinics of North America,14(2),289300.
[26] Berek, J. S., Howe, C.,Lagasse,L.D.,&Hacker,N.F.(2005).Pelvic exenteration for recurrent gynecologic malignancy: Survival and morbidity analysis of the 45-year experience at UCLA. Gynecologic Oncology, 99(1), 153–159.
[27] Maggioni, A., Roviglione, G., Landoni, F., Zanagnolo, V., Peiretti, M., Colombo, N., Morrow, C. P. (2009). Pelvic exenteration: Ten-year experience at the European Institute of Oncology in Milan. Gynecologic Oncology, 114(1), 64–68.
[28]Fotopoulou,C., Neumann,U., Kraetschell,R., Schefold,J.C., Weidemann,H., Lichtenegge, W., & Sehouli,J. (2010). Long-term clinical outcome of pelvic exenteration in patients with advanced gynecological malignancies.Journal of Surgical Oncology, 101(6), 507–512.
[29] Matsuo, K., Mandelbaum, R. S., Adams, C. L., Roman, L. D., & Wright, J. D. (2019). Performance and outcome of pelvic exenteration for gynecologic malignancies:Apopulation-based study. Gynecologic Oncology.
[30] Jalloul, R. J., Nick, A. M., Munsell, M. F., Westin, S. N., Ramirez, P. T., Frumovitz, M., & Soliman, P. T. (2018). The influence of surgeon volume on outcomes after pelvic exenteration for a gynecologic cancer. Journal of Gynecologic Oncology, 29(5).
[31] Wang, C.-J., Lai, C.-H., Huang, H.-J., Hong, J.-H., Chou, H.-H., Huang, K.-G., & Lin, J.-D. (1999). Recurrent cervical carcinoma after primary radical surgery. American Journal of Obstetrics and Gynecology,181(3), 518–524.
[32] Park, J.-Y., Choi, H. J., Jeong, S.-Y., Chung, J., Park, J. K., & Park, S.-Y. (2007). The role of pelvic exenteration and reconstruction for treatment of advanced or recurrent gynecologic malignancies: Analysis of risk factors predicting recurrence and survival. Journal of Surgical Oncology, 96(7), 560–568.
[33] (2019). Pelvic Exenteration for Advanced Nonrectal Pelvic Malignancy. Annals of Surgery, 270(5),899–905.
[34] Romeo, A., Gonzalez, M. I., Jaunarena, J., Zubieta, M. E., Favre, G., & Tejerizo, J. C. (2018). Exenteración pélvica para neoplasias ginecológicas: Complicaciones postoperatorias y resultados oncológicos. Actas Urológicas Españolas, 42(2), 121–125.
[35] Goldberg, G. L., Sukumvanich, P., Einstein, M. H., Smith, H. O., Anderson, P. S., & Fields, A. L. (2006). Total pelvic exenteration: The Albert Einstein College of Medicine/Montefiore Medical Center Experience (1987 to 2003).Gynecologic Oncology, 101(2), 261–268.
Published
2022-01-06
How to Cite
Crăciun, L., Isopescu, F., Edu, A., Bujor, M., Conci, S., Mateescu, R., Spânu, B., Dumitrașcu, M., Frîncu, F., & Mehedințu, C. (2022). THE ROLE OF PELVIC EXENTERATION IN TREATING GYNECOLOGIC MALIGNANCIES. Romanian Journal of Clinical Research, 4(2). https://doi.org/10.33695/rjcr.v4i2.73
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Articles
