Gynaecologic oncology centre, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic.
Gynaecologic oncology centre, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic.
Gynecol Oncol. 2022 Jul;166(1):100-107. doi: 10.1016/j.ygyno.2022.04.022. Epub 2022 May 12.
The aim of the study was to compare health-related quality of life (QoL) and oncological outcome between gynaecological cancer patients undergoing pelvic exenteration (PE) and extended pelvic exenteration (EPE). EPEs were defined as extensive procedures including, in addition to standard PE extent, the resection of internal, external, or common iliac vessels; pelvic side-wall muscles; large pelvic nerves (sciatic or femoral); and/or pelvic bones.
Data from 74 patients who underwent PE (42) or EPE (32) between 2004 and 2019 at a single tertiary gynae-oncology centre in Prague were analysed. QoL assessment was performed using EORTC QLQ-C30, EORTC CX-24, and QOLPEX questionnaires specifically developed for patients after (E)PE.
No significant differences in survival were observed between the groups (P > 0.999), with median overall and disease-specific survival in the whole cohort of 45 and 49 months, respectively. Thirty-one survivors participated in the QoL surveys (20 PE, 11 EPE). No significant differences were observed in global health status (P = 0.951) or in any of the functional scales. The groups were not differing in therapy satisfaction (P = 0.502), and both expressed similar, high willingness to undergo treatment again if they were to decide again (P = 0.317).
EPEs had post-treatment QoL and oncological outcome comparable to traditional PE. These procedures offer a potentially curative treatment option for patients with persistent or recurrent pelvic tumour invading into pelvic wall structures without further compromise of patients´ QoL.
本研究旨在比较接受盆腔廓清术（PE）和扩大盆腔廓清术（EPE）的妇科癌症患者的健康相关生活质量（QoL）和肿瘤学结果。EPE 被定义为广泛的手术，除了标准的 PE 范围外，还包括切除内部、外部或共同的髂血管；骨盆侧壁肌肉；大骨盆神经（坐骨或股神经）；和/或骨盆骨骼。
分析了 2004 年至 2019 年期间在布拉格的一家单中心妇科肿瘤学中心接受 PE（42 例）或 EPE（32 例）的 74 例患者的数据。使用 EORTC QLQ-C30、EORTC CX-24 和专门为（E）PE 后患者开发的 QOLPEX 问卷进行 QoL 评估。
两组患者的生存无显著差异（P > 0.999），全队列的中位总生存和疾病特异性生存分别为 45 个月和 49 个月。31 名幸存者参与了 QoL 调查（20 例 PE，11 例 EPE）。两组的总体健康状况（P = 0.951）或任何功能量表均无显著差异。两组在治疗满意度方面没有差异（P = 0.502），并且如果再次决定，两组都表示有相似的、高度愿意再次接受治疗（P = 0.317）。
EPE 治疗后的 QoL 和肿瘤学结果与传统的 PE 相当。这些手术为侵犯骨盆壁结构的持续性或复发性骨盆肿瘤患者提供了一种潜在的治愈性治疗选择，而不会进一步降低患者的 QoL。
