TOTAL PELVIC EXENTERATION - A 50-YEAR EXPERIENCE AT THE ELLIS-FISCHEL-CANCER-CENTER

Objective: To review a 50-year experience with to tal pelvic exenterat ion for treatment of advanced pelvic cancer. Design: Retrospective stu dy with 100% follow-up. Setting: Cancer hospital. Patients: Two hundre d 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 surviva l. Results: The morbidity rate was 45%. The operative death rate was 1 4% during the 50-year period, but decreased from 16.8% in the first th ree decades to 10% thereafter. Eighty-nine patients (38%) had recurren ces. The overall 5-year survival rate was 42%. Conclusions: Operative mortality and morbidity have declined over 50 years, largely because o f proper patient selection, increasing experience, and advances in per ioperative care. Exenteration has a major role in the treatment of adv anced pelvic cancer.