Bouraoui Imen, Bouaziz Hanen, Tounsi Nesrine, Ben Romdhane Racha, Hechiche Monia, Slimane Maher, Rahal Khaled
Department of Surgical Oncology, Salah Azaiez Institute, Tunis, Tunisia.
J Obstet Gynaecol India. 2022 Feb;72(1):66-71. doi: 10.1007/s13224-021-01502-0. Epub 2021 Jun 11.
The purpose of this work was to identify the results of pelvic exenteration for recurrent, persistent or locally advanced cervical cancer in terms of survival performed for 41 patients in Salah Azaiez Institute.
We conducted a retrospective unicentric study. The association between PE and OS was estimated using the method of Kaplan-Meier using SPSS ver 24.
Median age at the time of intervention was 53.9 years old. FIGO stage IIB was the most frequent (46.3%). Eighteen patients had pelvic exenteration after neoadjuvant treatment. Resection margins were free of tumor in 83.3% of cases. Twenty-three patients underwent pelvic exenteration for recurrence of cervical cancer treated. The median time of recurrence was 23.4 months. Free resection margins were obtained in 69.5% of cases. Postoperative complications were noted in 61% of patients. Two deaths were seen in the early postoperative period. After a median follow-up of 40.5 months, 24.4% of recurrences were noted. Overall survival at 5 years was 51% and recurrence-free survival at one year was 39%. Prognostic factors which impact overall and recurrence-free survival were the size of recurrence and resection margins after exenteration. The time between the end of initial treatment and recurrence was the only predictive factor of recurrence after pelvic exenteration.
Pelvic exenteration remains a curative treatment of cervical cancer in certain indications despite high morbidity. A rigorous preoperative selection of candidate may reduce the morbidity and improve the survival of patients.
本研究旨在确定在萨拉赫·阿扎耶兹研究所对41例复发性、持续性或局部晚期宫颈癌患者进行盆腔脏器清除术的生存结果。
我们进行了一项回顾性单中心研究。使用SPSS 24版的Kaplan-Meier方法评估盆腔脏器清除术(PE)与总生存期(OS)之间的关联。
干预时的中位年龄为53.9岁。国际妇产科联盟(FIGO)IIB期最为常见(46.3%)。18例患者在新辅助治疗后接受了盆腔脏器清除术。83.3%的病例切缘无肿瘤。23例患者因复发性宫颈癌接受盆腔脏器清除术。复发的中位时间为23.4个月。69.5%的病例获得了切缘阴性。61%的患者出现术后并发症。术后早期有2例死亡。中位随访40.5个月后,发现24.4%的患者复发。5年总生存率为51%,1年无复发生存率为39%。影响总生存期和无复发生存期的预后因素是复发大小和盆腔脏器清除术后的切缘情况。初始治疗结束至复发的时间是盆腔脏器清除术后复发的唯一预测因素。
尽管发病率高,但在某些适应症中,盆腔脏器清除术仍是宫颈癌的一种根治性治疗方法。对候选患者进行严格的术前筛选可能会降低发病率并提高患者生存率。