A systematic review and meta-analysis on mortality rate following total pelvic exenteration in cancer patients

• Published in: BMC cancer 2024-05, Vol.24 (1), p.593-18, Article 593
• Main Authors: Esmailzadeh, Arezoo, Fakhari, Mohammad Sadegh, Saedi, Nafise, Shokouhi, Nasim, Almasi-Hashiani, Amir
• Format: Article
• Language: English
• Subjects: Analysis; Cancer; Cancer patients; Care and treatment; Cohort analysis; Colorectal cancer; Colorectal neoplasms; Computer software industry; Female; Genital Neoplasms, Female - mortality; Genital Neoplasms, Female - surgery; Gynecological cancer; Gynecological neoplasms; Gynecology; Health aspects; Hospital Mortality; Hospitals; Humans; Male; Malignancy; Meta-analysis; Methods; Mortality; Neoplasms - mortality; Neoplasms - surgery; Organ removal; Patient outcomes; Patients; Pelvic exenteration; Pelvic Exenteration - mortality; Pelvis; Postoperative period; Reproductive organs; Software; Surgery; Surgical clinics; Surgical outcomes; Survival analysis; Systematic Review; Total pelvic exenteration; United States; Urologic neoplasms; Urological cancer
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/s12885-024-12377-5

Total pelvic exenteration (TPE), an en bloc resection is an ultraradical operation for malignancies, and refers to the removal of organs inside the pelvis, including female reproductive organs, lower urological organs and involved parts of the digestive system. The aim of this meta-analysis is to estimate the intra-operative mortality, in-hospital mortality, 30- and 90-day mortality rate and overall mortality rate (MR) following TPE in colorectal, gynecological, urological, and miscellaneous cancers. This is a systematic review and meta-analysis in which three international databases including Medline through PubMed, Scopus and Web of Science on November 2023 were searched. To screen and select relevant studies, retrieved articles were entered into Endnote software. The required information was extracted from the full text of the retrieved articles by the authors. Effect measures in this study was the intra-operative, in-hospital, and 90-day and overall MR following TPE. All analyzes are performed using Stata software version 16 (Stata Corp, College Station, TX). In this systematic review, 1751 primary studies retrieved, of which 98 articles (5343 cases) entered into this systematic review. The overall mortality rate was 30.57% in colorectal cancers, 25.5% in gynecological cancers and 12.42% in Miscellaneous. The highest rate of mortality is related to the overall mortality rate of colorectal cancers. The MR in open surgeries was higher than in minimally invasive surgeries, and also in primary advanced cancers, it was higher than in recurrent cancers. In conclusion, it can be said that performing TPE in a specialized surgical center with careful patient eligibility evaluation is a viable option for advanced malignancies of the pelvic organs.