Steffens Daniel, Solomon Michael J, Karunaratne Sascha, Brown Kilian, Kim Bora, Lee Peter, Austin Kirk, Byrne Christopher, Whitehead Lilian, Koh Cherry
Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia.
Br J Surg. 2025 May 31;112(6). doi: 10.1093/bjs/znaf123.
Pelvic exenteration is a curative treatment option for selected patients with advanced primary or recurrent pelvic cancer. This study aimed to evaluate survival and quality-of-life outcomes beyond 10 and up to 17 years following pelvic exenteration.
This longitudinal study included patients who underwent pelvic exenteration between 2008 and 2014. Quality of life was assessed using Short-Form Survey (SF-36v2) and Functional Assessment of Cancer Therapy-Colorectal Cancer (FACT-C) questionnaires at 10 different time points from baseline up to 17 years following pelvic exenteration. Survival data were obtained through registry linkage, with outcomes analysed using Kaplan-Meier methods.
Of the 273 patients included (median age 61.0 years, 59.3% male), 91 (33%) survived beyond 10 years. Median overall survival was 4.8 years (95% c.i. = 3.6 to 6.0), with survival rates of 48.4%, 35.1%, and 31.5% at 5, 10, and 15 years respectively. In the 216/273 (79.1%) patients who consented to participate in quality-of-life surveys, 32 (15%) completed surveys beyond 10 years. FACT-C scores showed steady improvement over the first 18 months, maintaining thereafter. Mental Component Summary scores approached population norms after initial improvement, while Physical Component Summary scores stayed within the population norm and remained stable throughout the follow-up period.
In a specialized setting, pelvic exenteration shows promising long-term outcomes with one-third of patients surviving beyond 10 years. Quality-of-life measures demonstrate sustained improvement and are comparable to population norms in several domains, supporting its use as a curative treatment for selected patients with advanced and recurrent pelvic malignancies.
盆腔脏器切除术是针对部分晚期原发性或复发性盆腔癌患者的一种根治性治疗选择。本研究旨在评估盆腔脏器切除术后10年至17年的生存情况和生活质量结果。
这项纵向研究纳入了2008年至2014年间接受盆腔脏器切除术的患者。使用简短调查（SF-36v2）和癌症治疗功能评估-结直肠癌（FACT-C）问卷，在盆腔脏器切除术后从基线到17年的10个不同时间点评估生活质量。通过登记链接获取生存数据，使用Kaplan-Meier方法分析结果。
纳入的273例患者（中位年龄61.0岁，59.3%为男性）中，91例（33%）存活超过10年。中位总生存期为4.8年（95%置信区间=3.6至6.0），5年、10年和15年的生存率分别为48.4%、35.1%和31.5%。在同意参与生活质量调查的216/273例（79.1%）患者中，32例（15%）完成了超过10年的调查。FACT-C评分在前18个月稳步改善，此后保持稳定。心理成分总结评分在最初改善后接近人群 norms，而身体成分总结评分在整个随访期间保持在人群 norms范围内且保持稳定。
在专业环境中，盆腔脏器切除术显示出有希望的长期结果，三分之一的患者存活超过10年。生活质量指标显示持续改善，并且在几个领域与人群 norms相当，支持其作为部分晚期和复发性盆腔恶性肿瘤患者的根治性治疗方法。
