Pelvic exenteration for recurrent endometrial cancer

Pelvic exenteration is generally not considered an operation with curative value for women with recurrent endometrial carcinoma. We reviewed our exper ience with pelvic exenteration performed in patients with recurrent endomet rial adenocarcinoma from 1947 through 1994. A total of 44 patients were ide ntified, with a mean age of 60 years (range 35-69 years). Primary therapy u sually consisted of total abdominal hysterectomy with bilateral salpingo-oo phorectomy, with most receiving either pre- or postoperative radiotherapy. Prior to exenteration, 10 of 44 (23%) patients had never received any form of radiotherapy. The median interval between initial surgery and exenterati on was 28 months (range 2-189 months). The type of exenteration performed w as total in 23 patients (52%), anterior in 20 patients (46%), and posterior in 1 patient. Major postoperative complications occurred in 35 patients (8 0%) and included urinary/intestinal tract fistulas, pelvic abscess, septice mia, pulmonary embolism, and cerebrovascular accident. Median survival for the entire group of patients was 10.2 months. Nine patients (20%) achieved long-term survival (> 5 years). Pelvic exenteration for recurrent endometri al cancer is associated with a high operative morbidity and poor overall su rvival. Although only 20% of patients achieved long-term survival, this pro cedure remains the only potentially curative option for the few patients wi th central recurrence of endometrial cancer who have failed surgical and ra diation therapy. (C) 1999 Academic Press.