Mayer M, Bobin J Y, Colon J, Borg G
Bull Cancer. 1980;67(1):70-7.
From 1953 to 1972, 149 patients at Centre Leon Bérard, were treated by pelvic exenteration for carcinoma of the cervix. A review of the literature and of our cases showed that the mortality rate varied between 12 and 38 per cent according to the authors. In our experience, the final cause of death has been essentially pelvic reccurences within 18 months of the operation. For Ketcham, the patients died principally from metastases. To illustrate these results, criteria for patient selection for pelvic exenteration are outlined, with some suggestions for operative and post-operative management. The pre-operative medical status, the roentgenographic studies and finally exploratory laparotomy eliminated all but a very small number of patients, 15 to 20 per cent. Pelvic exenteration is appreciably beneficial only for this small group. Indeed, the exenteration is acceptable only when it does not result in excessive mutilation disproportinate with the chances of survival. It is conceivable only as curative treatment requiring a radical loco-regional excision, not only for the involved viscerae but also for the pelvic lymph nodes.
1953年至1972年间，里昂·贝拉尔中心对149例宫颈癌患者实施了盆腔脏器清除术。对文献及我们的病例进行回顾后发现，根据不同作者的报道，死亡率在12%至38%之间波动。以我们的经验来看，最终的死亡原因主要是术后18个月内盆腔复发。按照凯查姆的说法，患者主要死于转移。为说明这些结果，本文概述了盆腔脏器清除术患者的选择标准，并对手术及术后管理提出了一些建议。术前的身体状况、影像学检查以及最后的探查性剖腹术排除了绝大多数患者，仅剩下15%至20%的少数患者。盆腔脏器清除术仅对这一小部分患者有明显益处。实际上，只有当该手术不会导致与生存几率不相称的过度致残时，才是可接受的。它仅可被视为一种根治性治疗，需要进行根治性的局部区域切除，不仅要切除受累脏器，还要切除盆腔淋巴结。
