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April 1994

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

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)