Primary Pelvic Exenteration for Advanced Gynaecological Malignancies

Introduction: Indication of primary pelvic exenteration, without previous radiotherapy, is questionable in advanced stages of gynaecological malignancies.

Materials and Methods: 24 patients who underwent primary pelvic exenteration for pelvic malignancies were studied retrospectively. The indications were cervical (n=17), vaginal (n=4), bladder (n=2) and endometrial cancer (n=1).

Results: According to the type of exenteration, 14 were anterior and 10 total. Relying on the resection lines in relation with levator ani muscles, 14 were supralevatorial and 10 infralevatorial, of which five involved vulvectomy. Early complications occurred in 7 patients with 1 perioperative death.

Conclusions: Primary pelvic exenterantion as first line therapy for advanced gynaecological malignancies can lead to long-term survival and it can even be curative in suitable selected patients. Still, postoperative complications are frequent, which can be lethal.