Pelvic exenteration for gynaecological cancer: a 10-year cohort analysis from a tertiary centre in the UK

Background: Pelvic exenteration provides a valuable curative treatment option for recurrent or persistent gynaecological malignancies. This case series describes the surgical outcomes and complications of pelvic exenteration surgery in patients with recurrent or persistent gynaecological cancer over a 10-year period at a tertiary university teaching hospital. Methods: Data were collected from the electronic medical record system (Epic Systems) at Cambridge University Hospital between October 2014 and 15 September 2023. The study was conducted as part of a service evaluation. Data were collected and analyzed for patient characteristics, pre-exenteration primary treatment profiles, perioperative complications, survival profiles and follow-up duration. Results: Out of 136 pelvic exenterations performed during the study period, 16 were undertaken for gynaecological cancer. The median age at the time of exenteration was 59.5 years (interquartile range (IQR), 55–66 years). Cervical cancer was the most common primary tumor (5/16, 31.3%). Three patients had vulvar cancer (18.8%), two had vaginal cancer (12.5%), and three had uterine cancer (18.8%). We observed severe (III/IV) complications in 3 out of 16 patients within 30 days of postoperative period. There were no postoperative deaths within 30 days. The median follow-up period was 37.1 months (95% confidence interval (CI): 26.4–47.7). No mortality occurred within 90 days, and the 5-year survival rate was 43.8% (7/16). Conclusions: With a carefully selected patient group, pelvic exenteration represents a safe and curative approach for recurrent or persistent gynaecological cancers.