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Cibula D, Lednický Š, Höschlová E, Sláma J, Wiesnerová M, Mitáš P, Matějovský Z, Schneiderová M, Dundr P, Němejcová K, Burgetová A, Zámečník L, Vočka M, Kocián R, Frühauf F, Dostálek L, Fischerová D, Borčinová M. Quality of life after extended pelvic exenterations. Gynecol Oncol 2022; 166:100-107. [PMID: 35568583 DOI: 10.1016/j.ygyno.2022.04.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/27/2022] [Accepted: 04/29/2022] [Indexed: 12/11/2022]
Abstract
BACKGROUND The aim of the study was to compare health-related quality of life (QoL) and oncological outcome between gynaecological cancer patients undergoing pelvic exenteration (PE) and extended pelvic exenteration (EPE). EPEs were defined as extensive procedures including, in addition to standard PE extent, the resection of internal, external, or common iliac vessels; pelvic side-wall muscles; large pelvic nerves (sciatic or femoral); and/or pelvic bones. METHODS Data from 74 patients who underwent PE (42) or EPE (32) between 2004 and 2019 at a single tertiary gynae-oncology centre in Prague were analysed. QoL assessment was performed using EORTC QLQ-C30, EORTC CX-24, and QOLPEX questionnaires specifically developed for patients after (E)PE. RESULTS No significant differences in survival were observed between the groups (P > 0.999), with median overall and disease-specific survival in the whole cohort of 45 and 49 months, respectively. Thirty-one survivors participated in the QoL surveys (20 PE, 11 EPE). No significant differences were observed in global health status (P = 0.951) or in any of the functional scales. The groups were not differing in therapy satisfaction (P = 0.502), and both expressed similar, high willingness to undergo treatment again if they were to decide again (P = 0.317). CONCLUSIONS EPEs had post-treatment QoL and oncological outcome comparable to traditional PE. These procedures offer a potentially curative treatment option for patients with persistent or recurrent pelvic tumour invading into pelvic wall structures without further compromise of patients´ QoL.
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Affiliation(s)
- D Cibula
- Gynaecologic oncology centre, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic.
| | - Š Lednický
- Gynaecologic oncology centre, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic
| | - E Höschlová
- Department of Psychology, Faculty of Arts, Charles University in Prague, Czech Republic
| | - J Sláma
- Gynaecologic oncology centre, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic
| | - M Wiesnerová
- Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic
| | - P Mitáš
- Second surgical clinic - cardiovascular surgery, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic
| | - Z Matějovský
- Department of Orthopaedics, First Faculty of Medicine, Charles University and Hospital Na Bulovce, Czech Republic
| | - M Schneiderová
- First surgical clinic - thoracic, abdominal and injury surgery, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic
| | - P Dundr
- Department of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic
| | - K Němejcová
- Department of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic
| | - A Burgetová
- Department of radiology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic
| | - L Zámečník
- Clinic of urology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic
| | - M Vočka
- Department of Oncology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic
| | - R Kocián
- Gynaecologic oncology centre, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic
| | - F Frühauf
- Gynaecologic oncology centre, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic
| | - L Dostálek
- Gynaecologic oncology centre, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic
| | - D Fischerová
- Gynaecologic oncology centre, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic
| | - M Borčinová
- Gynaecologic oncology centre, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic
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