Quality of life after extended pelvic exenterations

• Published in: Gynecologic oncology 2022-07, Vol.166 (1), p.100-107
• Main Authors: Cibula, D., Lednický, Š., Höschlová, E., Sláma, J., Wiesnerová, M., Mitáš, P., Matějovský, Z., Schneiderová, M., Dundr, P., Němejcová, K., Burgetová, A., Zámečník, L., Vočka, M., Kocián, R., Frühauf, F., Dostálek, L., Fischerová, D., Borčinová, M.
• Format: Article
• Language: English
• Subjects: Gynaecological cancer; Health-related quality of life; LEER; Out-of-box procedures; Pelvic exenteration
• ISSN: 0090-8258; 1095-6859
• DOI: 10.1016/j.ygyno.2022.04.022

The aim of the study was to compare health-related quality of life (QoL) and oncological outcome between gynaecological cancer patients undergoing pelvic exenteration (PE) and extended pelvic exenteration (EPE). EPEs were defined as extensive procedures including, in addition to standard PE extent, the resection of internal, external, or common iliac vessels; pelvic side-wall muscles; large pelvic nerves (sciatic or femoral); and/or pelvic bones. Data from 74 patients who underwent PE (42) or EPE (32) between 2004 and 2019 at a single tertiary gynae-oncology centre in Prague were analysed. QoL assessment was performed using EORTC QLQ-C30, EORTC CX-24, and QOLPEX questionnaires specifically developed for patients after (E)PE. No significant differences in survival were observed between the groups (P > 0.999), with median overall and disease-specific survival in the whole cohort of 45 and 49 months, respectively. Thirty-one survivors participated in the QoL surveys (20 PE, 11 EPE). No significant differences were observed in global health status (P = 0.951) or in any of the functional scales. The groups were not differing in therapy satisfaction (P = 0.502), and both expressed similar, high willingness to undergo treatment again if they were to decide again (P = 0.317). EPEs had post-treatment QoL and oncological outcome comparable to traditional PE. These procedures offer a potentially curative treatment option for patients with persistent or recurrent pelvic tumour invading into pelvic wall structures without further compromise of patients´ QoL. •Health-related quality of life is similar after pelvic exenteration (PE) and extended pelvic exenteration (EPE).•After both types of surgical procedures, patients reported good global health status.•All patients reported a good level of physical, emotional, and cognitive functions with decline in role and social functions.•No significant difference in symptoms´ severity or burden was found between the two groups.•No significant difference in survival was found between patients after PE and EPE.