Konstantinos Palaiologos, Rebecca Karkia, Zoi Nikoloudaki, Ahmed Mohamed, Rebecca Lavelle, Susanne Booth, Marina Flynn, Christopher Helbren, Matthew Simms, Theo Giannopoulos
{"title":"盆腔外扩张术:英国一家三级癌症转诊中心的回顾性研究。","authors":"Konstantinos Palaiologos, Rebecca Karkia, Zoi Nikoloudaki, Ahmed Mohamed, Rebecca Lavelle, Susanne Booth, Marina Flynn, Christopher Helbren, Matthew Simms, Theo Giannopoulos","doi":"10.23736/S2724-606X.24.05337-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Pelvic exenteration (PE) is an extensive surgery that is indicated in cases of recurrent advanced gynecological cancer with curative and sometimes palliative intent. The procedure is associated with both high morbidity and mortality and as such is considered a highly specialist procedure. The aim of the study was to analyze surgical outcomes in women who underwent PE for advanced gynecological malignancy in a tertiary cancer referral center over 11 years.</p><p><strong>Methods: </strong>This is an observational retrospective single-center study. There were 17 patients included who underwent PE in Hull Royal Infirmary Hospital (Hull, UK) between 2010 and 2021. The main outcome measures were the perioperative complications, overall survival (OS), and recurrence free survival (RFS). Cumulative survival rates were reported at 1, 3 and 5 years. Univariate Cox regression analysis was undertaken to analyze factors that are prognostic for OS and RFS. Hazard Ratios (HR) with 95% confidence intervals (95% CI) were computed from the results of the Cox regression analyses. Kaplan-Meier survival curves were generated to visually display estimates of OS and RFS over the follow-up period.</p><p><strong>Results: </strong>The median age at the time of surgery was 63.0 (IQR: 48.0-71.0). All patients received surgery with curative intent and complete tumor resection (R0) was achieved in 94.1% of cases. An overall 5-year survival was achieved in 63.7% of patients. Mean overall survival (OS) was 8.4 years (95% CI: 7.78-9.02). The RFS was 5.0 years (95% CI: 4.13-5.87). Both OS and RFS were significantly negatively affected by the hospital stay (P=0.020 and P=0.035, respectively), but not by the type of surgery (P=0.263 and P=0.826, respectively).</p><p><strong>Conclusions: </strong>The results of the study demonstrated stable and comparable outcomes in patients undergoing pelvic exenteration.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":1.6000,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Pelvic exenteration: a retrospective study in a tertiary referral cancer center in the UK.\",\"authors\":\"Konstantinos Palaiologos, Rebecca Karkia, Zoi Nikoloudaki, Ahmed Mohamed, Rebecca Lavelle, Susanne Booth, Marina Flynn, Christopher Helbren, Matthew Simms, Theo Giannopoulos\",\"doi\":\"10.23736/S2724-606X.24.05337-5\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Pelvic exenteration (PE) is an extensive surgery that is indicated in cases of recurrent advanced gynecological cancer with curative and sometimes palliative intent. The procedure is associated with both high morbidity and mortality and as such is considered a highly specialist procedure. The aim of the study was to analyze surgical outcomes in women who underwent PE for advanced gynecological malignancy in a tertiary cancer referral center over 11 years.</p><p><strong>Methods: </strong>This is an observational retrospective single-center study. There were 17 patients included who underwent PE in Hull Royal Infirmary Hospital (Hull, UK) between 2010 and 2021. The main outcome measures were the perioperative complications, overall survival (OS), and recurrence free survival (RFS). Cumulative survival rates were reported at 1, 3 and 5 years. Univariate Cox regression analysis was undertaken to analyze factors that are prognostic for OS and RFS. Hazard Ratios (HR) with 95% confidence intervals (95% CI) were computed from the results of the Cox regression analyses. Kaplan-Meier survival curves were generated to visually display estimates of OS and RFS over the follow-up period.</p><p><strong>Results: </strong>The median age at the time of surgery was 63.0 (IQR: 48.0-71.0). All patients received surgery with curative intent and complete tumor resection (R0) was achieved in 94.1% of cases. An overall 5-year survival was achieved in 63.7% of patients. Mean overall survival (OS) was 8.4 years (95% CI: 7.78-9.02). The RFS was 5.0 years (95% CI: 4.13-5.87). 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引用次数: 0
摘要
背景:盆腔外扩张术(PE)是一种广泛的手术,适用于复发性晚期妇科癌症,具有治愈性,有时也有姑息性。该手术与高发病率和高死亡率相关,因此被认为是一种高度专业的手术。本研究旨在分析一家三级癌症转诊中心 11 年来接受晚期妇科恶性肿瘤 PE 的妇女的手术结果:这是一项观察性回顾性单中心研究。方法:这是一项观察性回顾性单中心研究,共纳入了 2010 年至 2021 年期间在赫尔皇家医院(英国赫尔市)接受 PE 治疗的 17 名患者。主要结果指标为围术期并发症、总生存率(OS)和无复发生存率(RFS)。报告了1年、3年和5年的累积生存率。采用单变量 Cox 回归分析来分析 OS 和 RFS 的预后因素。根据考克斯回归分析的结果计算出危险比(HR)和 95% 置信区间(95% CI)。生成卡普兰-梅耶生存曲线,直观显示随访期间OS和RFS的估计值:手术时的中位年龄为 63.0(IQR:48.0-71.0)。所有患者均接受了根治性手术,94.1%的病例实现了肿瘤完全切除(R0)。63.7%的患者获得了5年总生存期。平均总生存期(OS)为8.4年(95% CI:7.78-9.02)。RFS为5.0年(95% CI:4.13-5.87)。OS和RFS均受到住院时间的明显负面影响(分别为P=0.020和P=0.035),但不受手术类型的影响(分别为P=0.263和P=0.826):研究结果表明,接受骨盆外展术的患者的预后稳定且具有可比性。
Pelvic exenteration: a retrospective study in a tertiary referral cancer center in the UK.
Background: Pelvic exenteration (PE) is an extensive surgery that is indicated in cases of recurrent advanced gynecological cancer with curative and sometimes palliative intent. The procedure is associated with both high morbidity and mortality and as such is considered a highly specialist procedure. The aim of the study was to analyze surgical outcomes in women who underwent PE for advanced gynecological malignancy in a tertiary cancer referral center over 11 years.
Methods: This is an observational retrospective single-center study. There were 17 patients included who underwent PE in Hull Royal Infirmary Hospital (Hull, UK) between 2010 and 2021. The main outcome measures were the perioperative complications, overall survival (OS), and recurrence free survival (RFS). Cumulative survival rates were reported at 1, 3 and 5 years. Univariate Cox regression analysis was undertaken to analyze factors that are prognostic for OS and RFS. Hazard Ratios (HR) with 95% confidence intervals (95% CI) were computed from the results of the Cox regression analyses. Kaplan-Meier survival curves were generated to visually display estimates of OS and RFS over the follow-up period.
Results: The median age at the time of surgery was 63.0 (IQR: 48.0-71.0). All patients received surgery with curative intent and complete tumor resection (R0) was achieved in 94.1% of cases. An overall 5-year survival was achieved in 63.7% of patients. Mean overall survival (OS) was 8.4 years (95% CI: 7.78-9.02). The RFS was 5.0 years (95% CI: 4.13-5.87). Both OS and RFS were significantly negatively affected by the hospital stay (P=0.020 and P=0.035, respectively), but not by the type of surgery (P=0.263 and P=0.826, respectively).
Conclusions: The results of the study demonstrated stable and comparable outcomes in patients undergoing pelvic exenteration.