Total Pelvic Exenteration

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Abstract
Objective: To review a 50-year experience with total pelvic exenteration for treatment of advanced pelvic cancer. Design: Retrospective study with 100% follow-up. Setting: Cancer hospital. Patients: Two hundred thirty-two patients referred for treatment of advanced pelvic cancer who underwent total pelvic exenteration. Main Outcome Measures: Rates of operative mortality, complications, recurrence, and 5-year survival. Results: The morbidity rate was 45%. The operative death rate was 14% during the 50-year period, but decreased from 16.8% in the first three decades to 10% thereafter. Eighty-nine patients (38%) had recurrences. The overall 5-year survival rate was 42%. Conclusions: Operative mortality and morbidity have declined over 50 years, largely because of proper patient selection, increasing experience, and advances in perioperative care. Exenteration has a major role in the treatment of advanced pelvic cancer. (Arch Surg. 1994;129:390-396)