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A Systematic Review and Meta-Analysis on Mortality Rate Following Total Pelvic Exenteration in Cancer Patients Publisher Pubmed



Esmailzadeh A1 ; Fakhari MS3 ; Saedi N4 ; Shokouhi N5 ; Almasihashiani A6, 7
Authors
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Authors Affiliations
  1. 1. Department of Obstetrics & amp
  2. 2. Gynecology, Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
  3. 3. Student Research Committee, Arak University of Medical Sciences, Arak, Iran
  4. 4. Fellowship of Perinatology, Department of Gynecologic Oncology, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Fellowship of Female Pelvic Medicine and Reconstructive Surgery, Yas Women Hospital, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Department of Epidemiology, Arak University of Medical Sciences, Arak, Iran
  7. 7. Traditional and Complementary Medicine Research Center, Arak University of Medical Sciences, Arak, Iran

Source: BMC Cancer Published:2024


Abstract

Background: Total pelvic exenteration (TPE), an en bloc resection is an ultraradical operation for malignancies, and refers to the removal of organs inside the pelvis, including female reproductive organs, lower urological organs and involved parts of the digestive system. The aim of this meta-analysis is to estimate the intra-operative mortality, in-hospital mortality, 30- and 90-day mortality rate and overall mortality rate (MR) following TPE in colorectal, gynecological, urological, and miscellaneous cancers. Methods: This is a systematic review and meta-analysis in which three international databases including Medline through PubMed, Scopus and Web of Science on November 2023 were searched. To screen and select relevant studies, retrieved articles were entered into Endnote software. The required information was extracted from the full text of the retrieved articles by the authors. Effect measures in this study was the intra-operative, in-hospital, and 90-day and overall MR following TPE. All analyzes are performed using Stata software version 16 (Stata Corp, College Station, TX). Results: In this systematic review, 1751 primary studies retrieved, of which 98 articles (5343 cases) entered into this systematic review. The overall mortality rate was 30.57% in colorectal cancers, 25.5% in gynecological cancers and 12.42% in Miscellaneous. The highest rate of mortality is related to the overall mortality rate of colorectal cancers. The MR in open surgeries was higher than in minimally invasive surgeries, and also in primary advanced cancers, it was higher than in recurrent cancers. Conclusion: In conclusion, it can be said that performing TPE in a specialized surgical center with careful patient eligibility evaluation is a viable option for advanced malignancies of the pelvic organs. © The Author(s) 2024.
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