Pelvic Exenteration for Recurrent and Persistent Cervical Cancer

Lei Li, Shui-Qing Ma, Xian-Jie Tan, Sen Zhong, Ming Wu, Lei Li, Shui-Qing Ma, Xian-Jie Tan, Sen Zhong, Ming Wu

Abstract

Background: Pelvic exenteration (PE) for primary and recurrent cervical cancer has resulted in favorable survival outcomes, but there are controversies about specific prognosis factors, and up to now, there have been no published reports from China. This study aimed to share our experiences of PE, which were performed in a single institution.

Methods: From January 2009 to January 2016, 38 patients with recurrent or persistent cervical cancer were included in the study, and they were followed up until January 2017. Epidemiological and clinicopathological characteristics of patients were compared for survival outcomes in univariate and Cox hazard regression analysis.

Results: There were thirty-one and seven patients with recurrent and persistent cervical cancer, respectively. The median age of patients was 45 years (range 29-65 years). Total, anterior, and posterior PE consisted of 52.6%, 28.9%, and 18.4% of cases, respectively. Early and late complications occurred in 21 (55.3%) patients and 15 (39.5%) patients, respectively. Two (5.3%) patients died due to complications related to surgeries within 3 months after PE. The median overall survival (OS) and disease-free survival (DFS) were 28.5 months (range 9-96 months) and 23 months (range 4-96 months), respectively, and 5-year OS and DFS were 48% and 40%, respectively. Cox hazard regression analysis showed that, the margin status of the incision and mesorectal lymph node status were independent risk factors for OS and DFS.

Conclusion: In our patients with recurrent and persistent cervical cancer, the practice of PE might achieve favorable survival outcomes.

Trial registration: ClinicalTrials.gov, NCT03291275; https://ichgcp.net/clinical-trials-registry/NCT03291275?term=NCT03291275&rank=1.

Keywords: Cervical Cancer; Pelvic Exenteration; Survival.

Conflict of interest statement

There are no conflicts of interest

Figures

Figure 1
Figure 1
OS curves of the patients described by Kaplan-Meier tests. (a) OS of positive and negative margins of the incisions (χ2=19.325, P value of log-rank test <0.001). (b) OS of positive and negative mesorectal lymph nodes (χ2= 7.060, P value of log-rank test is 0.008). OS: Overall survival.
Figure 2
Figure 2
DFS curves of the patients described by Kaplan-Meier tests. (a) DFS of positive and negative margins of the incisions (χ2=18.524, P value of log-rank test <0.001). (b) DFS of positive and negative mesorectal lymph nodes (χ2=5.909, P value of log-rank test is 0.019). DFS: Disease-free survival.

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