April 1994

Total Pelvic ExenterationA 50-Year Experience at the Ellis Fischel Cancer Center

Author Affiliations

From the Department of Surgery, St Elizabeth's Medical Center of Boston, Tufts University School of Medicine (Dr Lopez), Boston, Mass, and the Ellis Fischel Cancer Center, University of Missouri-Columbia (Drs Standiford and Skibba).

Arch Surg. 1994;129(4):390-396. doi:10.1001/archsurg.1994.01420280062008

Objective:  To review a 50-year experience with total pelvic exenteration for treatment of advanced pelvic cancer.

Design:  Retrospective study with 100% follow-up.

Setting:  Cancer hospital.

Patients:  Two hundred thirty-two patients referred for treatment of advanced pelvic cancer who underwent total pelvic exenteration.

Main Outcome Measures:  Rates of operative mortality, complications, recurrence, and 5-year survival.

Results:  The morbidity rate was 45%. The operative death rate was 14% during the 50-year period, but decreased from 16.8% in the first three decades to 10% thereafter. Eighty-nine patients (38%) had recurrences. The overall 5-year survival rate was 42%.

Conclusions:  Operative mortality and morbidity have declined over 50 years, largely because of proper patient selection, increasing experience, and advances in perioperative care. Exenteration has a major role in the treatment of advanced pelvic cancer.(Arch Surg. 1994;129:390-396)