PELVIC EXENTERATION FOR ADENOCARCINOMA OF THE UTERINE CERVIX

The objective of this study was to describe and compare the outcome of patients with recurrent adenocarcinoma versus squamous cell carcinoma of the uterine cervix who have been treated with pelvic exenteration. All patients undergoing pelvic exenteration for cervical adenocarcino ma from 1955 to 1989 were identified and a retrospective review was co nducted. For these 35 patients, we identified 70 controls who had exen teration for squamous cell carcinoma and who were matched for node sta tus, year of procedure, and type of procedure. No significant differen ce was noted between the control group and the adenocarcinoma group fo r size of recurrent tumor, status of margins, presence of hydronephros is prior to exenteration, and the time elapsed from initial diagnosis to exenteration. The two groups were compared for survival and recurre nce pattern. Median patient age was 47 years (range 22-70). All patien ts had prior pelvic radiotherapy. Thirty patients had total pelvic exe nteration and 5 had anterior exenteration. There were 3 postoperative deaths (8.6%). Median survival was 38 months for the adenocarcinoma pa tients and 25 months for the squamous patients (P > 0.99). The overall survival between the two sets of patients was very similar (log rank P = 0.86). There were 23 postexenteration recurrences among the adenoc arcinomas (22 in which the site is known) and 32 postexenteration recu rrences among the squamous patients (30 with known site). For the aden ocarcinoma patients, 14 of 22 had a distant recurrence versus 14 of 30 for the squamous patients (P = 0.27). Patients with central recurrenc e of cervical adenocarcinoma can be successfully treated with pelvic e xenteration and have survival rates similar to squamous carcinoma. (C) 1995 Academic Press, Inc