669 Outcomes, Morbidity and Mortality Following Pelvic Exenterations at Cambridge University Hospitals

Abstract Aim To evaluate patient outcomes following pelvic exenteration (PE) within the colorectal department, specifically length of admission, morbidity, and mortality over a 7-year period. Objective To identify factors affecting patient outcomes following PE. Method Data collected retrospectively on all colorectal patients who underwent PE from 2015 to 2022 at Addenbrooke’s Hospital, Cambridge, UK. Results 89 patients underwent PE for colorectal cancer, with mean age 62.69 and male to female ratio 2:1. 74% had rectal adenocarcinoma, R0 resection was achieved in 82%. 82% experienced complications, most notably intra-abdominal collections (52%); this resulted in significantly longer admissions (p<0.01). Length of admission was higher in patients undergoing PE for cancer recurrence (p 0.048). Median survival was 68 months, and on multivariate Kaplan-Meyer analysis R0 resection was found to be the only significant factor affecting survival (p <0.01). In-patient mortality was 8% and 12-month mortality at 16%. Conclusions A similar study by Choy et al. 2017 reported 16% 12-month mortality and 87% post-operative complications, marginally higher than our findings. In comparison, our study examined a wider range of factors affecting PE outcomes and identified significance of R0 resection. Our study has one of the highest patient cohorts in literature and findings are consistent with similar studies. Complications following PE are common, the most frequent being intra-abdominal collections. Although morbidity is high, most patients survive over 3 years; the only factor affecting survival appears to be R0 resection.