OJOG  Vol.3 No.5 A , July 2013
Long term outcome and quality of life after pelvic exenteration for recurrent endometrial and cervical cancers
ABSTRACT

Introduction: Pelvic exenteration can cure recurrent gynecological malignancies. However, treatment morbidity is over 50% in radiated pelves. We evaluated the outcome, the morbidity and the quality of life after exenteration. Methods: Patients who underwent an exenteration for recurrent cervical or endometrial cancer in our institution between 1999 and 2011 were retrieved. Survival rates were calculated according to Kaplan-Meier method and compared using the logrank test. The EORTC QLQ-C30 and QLQ-CX24 questionnaires were sent to patients alive in January 2012. Results: We identified 25 patients: 17 (68%) had cervical cancer and 8 (32%) endometrial cancer. 92% of them had received radiotherapy previously. All patients had a central pelvic recurrence, within a median time of 30 months [4 - 384] from initial treatment. Early complications requiring a re-laparotomy occurred in 9 patients (36%). Late complications included 2 (8%) fistulas, 2 (8%) occlusion and 1 (4%)

ureteral stenosis. Complete resection was obtained in 92% of patients. Disease Free and Overall survival rates were better in cervical rather than in endometrial cancer (median DFS in months 17 [2 - 145] vs 9.5 [3 - 21], p = 0.064, median OS in months 20 [2 - 145] vs 13 [4 - 42], p = 0.019). 69% of patients answered the quality of life questionnaires. Mean global quality of life score was 45 on a scale of 0 - 100, none of the patients had a sexual activity. Conclusions: Morbidity of exenteration remains high and quality of life is altered. Endometrial cancer is associated with a poorer prognosis. In those patients, exenteration should be put in balance with best supportive care.


Cite this paper
Ngô, C. , Abboud, C. , Meria, P. , Fourchotte, V. , Mariani, P. , Baranger, B. , Sastre, X. , Malhaire, C. , Philippe, A. , Scholl, S. , Rochefordière, A. and Alran, S. (2013) Long term outcome and quality of life after pelvic exenteration for recurrent endometrial and cervical cancers. Open Journal of Obstetrics and Gynecology, 3, 19-27. doi: 10.4236/ojog.2013.35A1005.
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