432 Factors affecting recurrence following pelvic exenteration for gynecologic malignancies: a retrospective cohort study

Introduction/Background*

Pelvic exenteration is an ultraradical surgical procedure that is performed in patients with pelvic malignancies that refractory to primary treatment. The purpose of the present study is to evaluate differences in patient and tumor characteristics of patients that experience recurrence of the disease following the procedure to those that remain disease free.

Methodology

We conducted a retrospective study that was based on patient records of patients treated with pelvic exenteration in our department between 2006 and 2020. We sought to determine differences in terms of tumor and patients` characteristics that might influence the postoperative course of these patients.

Result(s)*

Ninety-four women were recruited of whom 33 developed recurrence. The median follow-up was 18 months (4 – 72 months). We observed that patients treated for recurrent disease had comparable relapse rates to those that were primarily treated with pelvic exenteration. Neither the presence of positive surgical margins (p=.546), nor the type of malignancy (p=.434) significantly differed among patients that developed recurrence and those that did not. Parametrial involvement and positive pelvic lymph nodes were also equally distributed among the two groups. Patients with refractory disease to chemotherapy had, however, substantial higher risk of relapse (p=.002). On the other hand, the percentage of patients that had been priorly treated with radiotherapy did not differ among the two groups (p=.859). Patients with parametrial involvement had significantly higher rates of local relapse (p=.035).

Conclusion*

The findings of our study reveal that it is still difficult to determine which proportion of patients that undergo pelvic exenteration will benefit from the procedure in terms of recurrence free rates. Patients with parametrial involvement are more likely to develop local relapse; however, this does not seem to be influenced by the presence of positive surgical margins. Larger studies are needed to fully elucidate this field.