Evaluation of the Short- and Long-Term Outcome Predictors in Patients Undergoing Posterior Pelvic Exenteration: A Single-Center Experience

Background: Pelvic exenteration (PE) is a radical surgery and is actually used to manage advanced cancers of differing origins. Risk factors for poor prognosis, correlated to this intervention, have been partially evaluated; thus it is useful to make an accurate assessment of the predictors correlated to short- and long-term outcomes with use of PE. Materials and Methods: A retrospective review was conducted involving 28 patients who underwent posterior PE, with curative intent; the procedure was performed for gynecologic and nongynecologic neoplasms at the University of Messina, Messina, Sicily, Italy. Results: The overall morbidity rate was 46.4%, the incidence of severe complications (grade 3/4) was 14%, and the perioperative mortality was 7.1%. A median survival of 29 months was recorded for the entire sample, with 3- and 5-year overall survivals of 37.5% and 16.7%, respectively. Conclusions: The only factor-when using a multivariate model-that was significantly associated with morbidity was Eastern Cooperative Oncology Group (ECOG) performance status. This study demonstrated that the origins of primary cancers did not affect patients' long-term survival significantly, while higher numbers of anastomoses, major complications, and, above all, higher ECOG scores were associated with shorter long-term survival. Based on the experience illustrated in this study, it is fundamentally important to select patients for treatment, paying special attention to their ECOG scores.