PELVIC EXENTERATION IN GYNECOLOGIC ONCOLOGY - EXPERIENCE AT THE MOUNT-SINAI MEDICAL-CENTER, 1975-1992

Thirty-nine patients underwent pelvic exenteration for gynecologic mal ignancies at The Mount Sinai Medical Center between 1975 and 1992. Sur gical techniques, morbidity, survival, and other variables for patient s so treated in two periods, 1975-1984 and 1985-1992, were compared. T he primary cancer included squamous cell carcinoma of the cervix, 27; adenocarcinoma of the cervix, 1; squamous cell carcinoma of the vagina , 4; adenocarcinoma of the endometrium, 4; squamous cell carcinoma of the vulva, 2; and adenocarcinoma of the rectum, 1. Median survival was 23.1 months, with a median follow-up of 18 months. Survival was signi ficantly related to status of the lymph nodes (p 0.0004) and surgical margins (p 0.0038). There were two postoperative mortalities, one due to pulmonary embolus and another to myocardial infarction. The ability in the second period analyzed, 1985-1992, to integrate a continent ur inary reservoir and supralevator exenteration without colostomy yet no t induce increased morbidity or decreased survival, has not been previ ously reported.