Glane Luisa Ter, Hegele Axel, Wagner Uwe, Boekhoff Jelena
Department of Urology and Pediatric Urology, University Hospital of Giessen and Marburg (UKGM), Marburg, Germany.
Urological Center Mittelhessen, DRK Hospital, Biedenkopf, Germany.
Cancer Diagn Progn. 2022 May 3;2(3):308-315. doi: 10.21873/cdp.10110. eCollection 2022 May-Jun.
BACKGROUND/AIM: Cervical cancer is the most common gynecological indication for pelvic exenteration (PE). It is an ultima ratio approach to cure advanced or recurring tumors. This study aimed to evaluate data from a Single Center Institution in order to assess morbidity, mortality and survival data.
Data of 24 patients, who underwent anterior (APE) or total PE (TPE) for cervical cancer at the University Hospital Marburg between 2011 and 2016, were extracted and retrospectively evaluated. Survival analysis was conducted using the Kaplan-Meyer method.
Lymph node status was pN0, pN1 and pNX in 33.3%, 20.8% and 45.8% respectively. Negative margins could be achieved in 70.8%. A total of 16.7% of patients presented with metastatic disease, while 20.8%, 37.5% and 20.8% received 1, 2 or 3 modalities of treatment respectively; 20.8% underwent up-front PE. Predominant urinary diversion was an ileum conduit (66.7%). No complications were noted for 16.7%, major complications (≥Clavien Dindo 3) in 41.7%. Overall survival was 29.2% with a median overall survival (mOS) of 19.1 months. Curative PE was undertaken in 20 cases, with 2- and 3-year survival rates of 52.6% and 29.4% respectively. and a mOS of 24 months. Positive margins, metastatic disease, positive lymph nodes, TPE and a surgical time >6 h had a significant impact on OS.
PE for cervical cancer remains a feasible option in cases of advanced or recurring tumors when alternative treatment options would fail. For selected patients it may represent a chance of cure with acceptable complication and satisfactory survival rates.
背景/目的：宫颈癌是盆腔脏器廓清术（PE）最常见的妇科适应证。它是治疗晚期或复发性肿瘤的最终手段。本研究旨在评估来自单一中心机构的数据，以评估发病率、死亡率和生存数据。
提取并回顾性评估了2011年至2016年间在马尔堡大学医院因宫颈癌接受前盆腔脏器廓清术（APE）或全盆腔脏器廓清术（TPE）的24例患者的数据。采用Kaplan-Meier法进行生存分析。
淋巴结状态分别为pN0、pN1和pNX的患者比例为33.3%、20.8%和45.8%。70.8%的患者能够实现切缘阴性。共有16.7%的患者出现转移性疾病，而分别有20.8%、37.5%和20.8%的患者接受了1、2或3种治疗方式；20.8%的患者接受了 upfront PE。主要的尿流改道方式为回肠导管（66.7%）。16.7%的患者未出现并发症，41.7%的患者出现严重并发症（≥Clavien Dindo 3级）。总生存率为29.2%，中位总生存期（mOS）为19.1个月。20例患者接受了根治性PE，2年和3年生存率分别为52.6%和29.4%，mOS为24个月。切缘阳性、转移性疾病、阳性淋巴结、TPE和手术时间>6小时对总生存期有显著影响。
对于晚期或复发性肿瘤，当其他治疗选择失败时，宫颈癌的PE仍然是一种可行的选择。对于选定的患者，它可能代表着治愈的机会，并发症可接受且生存率令人满意。
