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Bonvalot, S., de Baere, T., Mendiboure, J., Paci, A., Farace, F., Drouard-Troalen, L., Bonnet, L., Hakime, A., Bonniaud, G., Raynard, B., Israel, P., Le Cesne, A., Eggermont, A.M., Laplanche, A. and Muret, J. (2012) Hyperthermic pelvic perfusion with tumor necrosis factoralpha for locally advanced cancers: Encouraging results of a phase II study. Annals of Surgery, 255, 281-286. doi:10.1097/SLA.0b013e318242ebe7

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• TITLE: Long term outcome and quality of life after pelvic exenteration for recurrent endometrial and cervical cancers

  AUTHORS: Charlotte Ngô, Christelle Abboud, Paul Meria, Virginie Fourchotte, Pascale Mariani, Bernard Baranger, Xavier Sastre, Caroline Malhaire, Anne-Cécile Philippe, Suzy Scholl, Anne de la Rochefordière, Séverine Alran

  KEYWORDS: Pelvic Exenteration; Quality of Life; Recurrent Cervical Cancer; Recurrent Endometrial Cancer

  JOURNAL NAME: Open Journal of Obstetrics and Gynecology, Vol.3 No.5A, July 8, 2013

  ABSTRACT: Introduction: Pelvic exenteration can cure recurrent gynecological malignancies. However, treatment morbidity is over 50% in radiated pelves. We evaluated the outcome, the morbidity and the quality of life after exenteration. Methods: Patients who underwent an exenteration for recurrent cervical or endometrial cancer in our institution between 1999 and 2011 were retrieved. Survival rates were calculated according to Kaplan-Meier method and compared using the logrank test. The EORTC QLQ-C30 and QLQ-CX24 questionnaires were sent to patients alive in January 2012. Results: We identified 25 patients: 17 (68%) had cervical cancer and 8 (32%) endometrial cancer. 92% of them had received radiotherapy previously. All patients had a central pelvic recurrence, within a median time of 30 months [4 - 384] from initial treatment. Early complications requiring a re-laparotomy occurred in 9 patients (36%). Late complications included 2 (8%) fistulas, 2 (8%) occlusion and 1 (4%) ureteral stenosis. Complete resection was obtained in 92% of patients. Disease Free and Overall survival rates were better in cervical rather than in endometrial cancer (median DFS in months 17 [2 - 145] vs 9.5 [3 - 21], p = 0.064, median OS in months 20 [2 - 145] vs 13 [4 - 42], p = 0.019). 69% of patients answered the quality of life questionnaires. Mean global quality of life score was 45 on a scale of 0 - 100, none of the patients had a sexual activity. Conclusions: Morbidity of exenteration remains high and quality of life is altered. Endometrial cancer is associated with a poorer prognosis. In those patients, exenteration should be put in balance with best supportive care.