Background/Objectives: Pelvic exenteration (PE) might be a curative option for patients with advanced pelvic malignancies. Due to its significant morbidity and mortality rates, PE necessitates meticulous patient selection, and a comprehensive understanding of disease spread. This study outlines the experience at a single tertiary referral center and investigates prognostic factors influencing survival post-PE, thereby guiding clinical decision-making processes.Methods: Patients undergoing PE for advanced pelvic gynecological malignancies between 01/2016 and 12/2023 were retrospectively analyzed using a prospectively managed database. Eligibility for PE was determined through individualized tumor board evaluations based on CT/MRI imaging, excluding patients with distant metastases. Baseline demographic and clinical characteristics, operative details, complication rates, and histopathological findings were assessed using univariate and multivariate regression analyses. Disease-free (DFS) and overall survival (OS) were assessed by Kaplan-Meier analysis. Poor outcome prognostic factors were identified, outlining an optimal candidate profile for PE.Results: A total of 70 patients were included. The median age was 54.5 years. Forty-three patients (61.4%) presented with recurrent disease and the majority were diagnosed with cervical cancer (n = 48, 68.6%). Total PE was performed in 40 patients (57.1%), with complete tumor resection achieved in 68.6% of patients (n = 48). Sixteen patients (22.8%) experienced grade IV/V complications. Median DFS and OS were 8.2 and 16.4 months, respectively. Multivariate analysis identified R1 resection status and para-aortic lymph node involvement as independent negative prognostic factors.Conclusions: PE is a viable option for selected patients with advanced primary and recurrent pelvic gynecological malignancies. When complete tumor resection is feasible, patients may derive benefit from PE, although the risk of severe perioperative complications must be carefully evaluated.
**背景/目的：** 盆腔廓清术（PE）可能是晚期盆腔恶性肿瘤患者的一种根治性治疗选择。鉴于其较高的发病率和死亡率，PE需要细致的患者筛选以及对疾病扩散情况的全面了解。本研究总结了一家三级转诊中心的经验，并探讨影响PE术后生存的预后因素，从而为临床决策提供指导。 **方法：** 利用前瞻性管理的数据库，对2016年1月至2023年12月期间因晚期盆腔妇科恶性肿瘤接受PE的患者进行回顾性分析。PE的适用性通过基于CT/MRI影像的个体化肿瘤委员会评估确定，排除了存在远处转移的患者。采用单变量和多变量回归分析评估基线人口统计学和临床特征、手术细节、并发症发生率以及组织病理学结果。通过Kaplan-Meier分析评估无病生存期（DFS）和总生存期（OS）。确定了不良结局的预后因素，并勾勒出PE理想候选者的特征。 **结果：** 共纳入70例患者。中位年龄为54.5岁。43例患者（61.4%）为复发性疾病，大多数诊断为宫颈癌（n = 48, 68.6%）。40例患者（57.1%）接受了全盆腔廓清术，68.6%的患者（n = 48）实现了肿瘤完全切除。16例患者（22.8%）发生了IV/V级并发症。中位DFS和OS分别为8.2个月和16.4个月。多变量分析确定R1切除状态和腹主动脉旁淋巴结受累是独立的负面预后因素。 **结论：** 对于经过筛选的晚期原发性和复发性盆腔妇科恶性肿瘤患者，PE是一种可行的选择。当肿瘤完全切除可行时，患者可能从PE中获益，但必须仔细评估围手术期严重并发症的风险。
肿瘤(癌症)患者之家