Total pelvic exenteration. A 50-year experience at the Ellis Fischel Cancer Center.

OBJECTIVE: To review a 50-year experience with total pelvic exenteration for treatment of advanced pelvic cancer.

DESIGN: Retrospective study with 100% follow-up.

SETTING: Cancer hospital.

PATIENTS: Two hundred thirty-two patients referred for treatment of advanced pelvic cancer who underwent total pelvic exenteration.

MAIN OUTCOME MEASURES: Rates of operative mortality, complications, recurrence, and 5-year survival.

RESULTS: The morbidity rate was 45%. The operative death rate was 14% during the 50-year period, but decreased from 16.8% in the first three decades to 10% thereafter. Eighty-nine patients (38%) had recurrences. The overall 5-year survival rate was 42%.

CONCLUSIONS: Operative mortality and morbidity have declined over 50 years, largely because of proper patient selection, increasing experience, and advances in perioperative care. Exenteration has a major role in the treatment of advanced pelvic cancer.