Höckel M
Department of Obstetrics and Gynaecology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany.
Eur J Surg Oncol. 2006 Oct;32(8):859-65. doi: 10.1016/j.ejso.2006.03.040. Epub 2006 May 11.
To describe "ultra-radical" surgery in gynaecological oncology. This is multivisceral pelvic resection aimed at the eradication of locally advanced and recurrent gynaecologic cancer with microscopically tumour-free margins (R0).
Up-dated analysis of a prospective trial evaluating oncologic outcome and treatment-related morbidity of ultra-radical compartmentalized surgery carried out by the author.
From 8/1996 until 9/2005 74 patients with locally advanced and recurrent gynaecologic tumours have been treated with ultra-radical compartmentalized surgery. Eighteen patients with central disease underwent exenteration as multimesovisceral excision, 56 patients with pelvic side wall disease received laterally extended endopelvic resection. In 72 of the patients the tumours were removed with microscopically free margins (R0). Two patients with advanced age and extensive comorbidity respectively, died during the early postoperative period. Moderate and severe treatment-related morbidity was 66%. At a median follow-up period of 29 months (1-112 months) 5-year overall and recurrence-free survival probabilities are 56% (95% CI: 42-69) and 56% (42-70).
Ultra-radical compartmentalized pelvic surgery may salvage selected patients with locally advanced and recurrent gynaecologic malignancies including those with pelvic side wall disease traditionally not considered for surgical therapy.
描述妇科肿瘤学中的“超根治性”手术。这是一种多脏器盆腔切除术，旨在根除局部晚期和复发性妇科癌症，并达到显微镜下切缘无肿瘤（R0）。
对一项前瞻性试验进行更新分析，该试验评估了作者实施的超根治性分区手术的肿瘤学结局和治疗相关并发症。
从1996年8月至2005年9月，74例局部晚期和复发性妇科肿瘤患者接受了超根治性分区手术。18例中心型疾病患者接受了多脏器切除的盆腔廓清术，56例盆腔侧壁疾病患者接受了侧向扩大的盆腔内切除术。72例患者的肿瘤在显微镜下切缘无肿瘤（R0）的情况下被切除。分别有1例高龄患者和1例合并症广泛的患者在术后早期死亡。中度和重度治疗相关并发症发生率为66%。中位随访期为29个月（1 - 112个月），5年总生存率和无复发生存率分别为56%（95%CI：42 - 69）和56%（42 - 70）。
超根治性分区盆腔手术可能挽救部分局部晚期和复发性妇科恶性肿瘤患者，包括那些传统上不考虑手术治疗的盆腔侧壁疾病患者。
