|
KMID : 1137020240350010004
|
|
Journal of Gynecologic Oncology
2024 Volume.35 No. 1 p.4 ~ p.4
|
|
|
Predictive factors of surgical complications after pelvic exenteration for gynecological malignancies: a large single-institution experience
|
|
Lucia Tortorella
Cintoni Marco
Matteo Loverro
Conte Carmine
Eleonora Persichetti
Nicolo Bizzarri
Costantini Barbara
Santullo Francesco
Nazario Foschi
Valerio Gallotta
Giacomo Avesani
Vito Chiantera
Alfredo Ercoli
Francesco Fanfani
Anna Fagotti
Maria Cristina Mele
Stefano Restaino
Salvatore Gueli Alletti
Giovanni Scambia
Giuseppe Vizzielli
|
|
|
Abstract
|
|
|
Objective: To evaluate pre-operative predictors of early (<30 days) severe complications (grade Dindo 3+) in patients with gynecological malignancy submitted to pelvic exenteration (PE).
Methods: We retrospectively analyzed 129 patients submitted to surgery at Fondazione Policlinico Gemelli between 2010 and 2019. We included patients affected by primary or recurrent/persistent cervical, endometrial, or vulvar/vaginal cancers. Post-operative complications were graded according to the Dindo classification. Logistic regression was used to analyze potential predictors of complications.
Results: We performed 63 anterior PE, 10 posterior PE, and 56 total PE. The incidence of early severe post-operative complications was 27.9% (n=36), and the early mortality rate was 2.3% (n=3). More frequent complications were related to the urinary diversion and intestinal surgery. In univariable analysis, hemoglobin ≤10 g/dL (odds ratio [OR]=4.2; 95% confidence interval [CI]=1.65?10.7; p=0.003), low albumin levels (OR=3.9; 95% CI=1.27?12.11; p=0.025), diabetes (OR=4.15; 95% CI=1.22?14.1; p=0.022), 2+ comorbidities at presentation (OR=5.18; 95% CI=1.49?17.93; p=0.012) were predictors of early severe complications. In multivariable analysis, only low hemoglobin and comorbidities at presentation were independent predictors of complications.
Conclusion: Pelvic exenteration is an aggressive surgery characterized by a high rate of post-operative complications. Pre-operative assessment of comorbidities and patient health status are crucial to better select the right candidate for this type of surgery.
|
|
|
KEYWORD
|
|
|
Cervical Cancer, Endometrial Cancer, Pelvic Exenteration, Nutritional Status
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|
|