MULTIVARIATE-ANALYSIS OF FACTORS AFFECTING SURVIVAL IN PELVIC EXENTERATION

Of 153 patients with primary or recurrent pelvic malignancy referred f or consideration of exenteration, only 40.6% (62 patients) were found to be suitable for exenteration after full assessment. Thirty percent (46 patients) were found to be inoperable on examination under anesthe sia. Of the remaining 107 patients, 33% (35 patients) were found to be inoperable at laparotomy, 9% (10 patients) underwent radical hysterec tomy and 58% (62 patients) had an exenterative procedure. One patient had no active disease found on final histologic review of the exentera tion surgical specimen and was excluded, as the aim of this study was to look at the prognostic factors affecting survival. There remained 6 1 patients in the exenteration group who were analyzed. The 2-year sur vival rate was less than 2% for patients with inoperable disease, 48% for patients who underwent radical hysterectomy and 54.1% for patients who underwent exenteration. The 5-year survival rate for all patients undergoing exenteration for pelvic malignancies was 44% and that for cervical cancer only was 52%. Multivariate analysis of patients who ha d undergone exenteration showed four significantly poor prognostic fac tors influencing survival. They were: (a) aged older than 69 years, (b ) recurrence of the tumor within 3 years, (c) persistent recurrence, a nd (d) positive resection margins.