Exenteration as a primary treatment for locally advanced cervical cancer: long-term results and prognostic factors

Objective Whereas pelvic exenteration is an established therapy for the treatment of recurrent cervical carcinoma, it is not often performed for primary locally advanced cervical cancer (LACC). Study Design This retrospective study analyzed survival data and prognostic factors of 35 patients with LACC who were treated by pelvic exenteration. Results After surgery, 33 patients (97%) were macroscopically free of tumor. In 20 patients, pelvic lymph nodes (LN) were involved, and in 6 of these, metastatic tissue had reached the paraaortal nodes. Overall, the patients' mean 5 year survival was 43%, and the median survival time was 30 months; these values ranged from 15% to 70% and from 15 to 44 months, respectively, depending on LN involvement ( P = .006). Pelvic LN involvement was the only significant factor for overall survival found in the multivariate analysis ( P = .02). Conclusion In LACC with free LNs and no distant metastases, pelvic exenteration has good long-term results.