Out-of-the-box pelvic surgery including iliopsoas resection for recurrent gynecological malignancies: Does that make sense? A single-institution case-series

Vito Chiantera, Anna Fagotti, Di Giorgio, Giovanni Scambia, Valerio Gallotta, Tinelli, Giuseppe Vizzielli, Salvatore Gueli Alletti

Risultato della ricerca: Article

4 Citazioni (Scopus)

Abstract

Objective To report morbidity and oncological outcomes in a consecutive series of lateral isolated recurrent gynecological cancer involving the pelvic side wall (PSW) including the iliopsoas muscle. Material and methods We retrospectively evaluated a consecutive series between 6/2013 and 12/2015 of lateral isolated recurrent gynecological malignancies treated with a lateral endopelvic resection (LEPR). LEPR was defined as an en-bloc lateral resection of a pelvic tumor with sidewall muscle, and/or bone, and/or major nerve, and/or major vascular structure. Post-surgical complications, quality of life (QoL) and survivals were computed. Results Seventy-four women with pelvic isolated relapse were admitted for surgery during the study period. Among them, 8 cases (10.8%) showed lateral isolated relapse involving the iliopsoas muscle and were treated with LEPR. R0 resection was achieved in 6/8 patients (75.0%), while the pathologic margins were microscopically and macroscopically positive in 1 patient (12.5%), respectively. There were no perioperative mortalities. Major postoperative complications occurred in 3 patients (37.5%) through peripheral neuropathies, thrombosis of the vascular graft and compartment syndrome of the leg. Median follow-up time was 21 months (range, 12–28). The 2-year overall survival (OS) was 88% improving up to 100% if R0 resection was achieved. In patients with positive pathologic margins (n = 2), the 2-year OS was 50%. All women showed an improved QoL after surgery. Conclusion LEPR with iliopsoas resection can be safely performed in selected cases with lateral isolated gynecological relapse involving the PSW and was associated with improved QoL and prolonged survival when an R0 resection was achieved.
Lingua originaleEnglish
pagine (da-a)710-716
Numero di pagine7
RivistaEuropean Journal of Surgical Oncology
Volume43
Stato di pubblicazionePublished - 2017

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Survival
Quality of Life
Recurrence
Muscles
Blood Vessels
Neoplasms
Pelvic Neoplasms
Compartment Syndromes
Peripheral Nervous System Diseases
Leg
Thrombosis
Morbidity
Transplants
Bone and Bones
Mortality

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cita questo

Out-of-the-box pelvic surgery including iliopsoas resection for recurrent gynecological malignancies: Does that make sense? A single-institution case-series. / Chiantera, Vito; Fagotti, Anna; Di Giorgio; Scambia, Giovanni; Gallotta, Valerio; Tinelli; Vizzielli, Giuseppe; Gueli Alletti, Salvatore.

In: European Journal of Surgical Oncology, Vol. 43, 2017, pag. 710-716.

Risultato della ricerca: Article

Chiantera, Vito ; Fagotti, Anna ; Di Giorgio ; Scambia, Giovanni ; Gallotta, Valerio ; Tinelli ; Vizzielli, Giuseppe ; Gueli Alletti, Salvatore. / Out-of-the-box pelvic surgery including iliopsoas resection for recurrent gynecological malignancies: Does that make sense? A single-institution case-series. In: European Journal of Surgical Oncology. 2017 ; Vol. 43. pagg. 710-716.
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title = "Out-of-the-box pelvic surgery including iliopsoas resection for recurrent gynecological malignancies: Does that make sense? A single-institution case-series",
abstract = "Objective To report morbidity and oncological outcomes in a consecutive series of lateral isolated recurrent gynecological cancer involving the pelvic side wall (PSW) including the iliopsoas muscle. Material and methods We retrospectively evaluated a consecutive series between 6/2013 and 12/2015 of lateral isolated recurrent gynecological malignancies treated with a lateral endopelvic resection (LEPR). LEPR was defined as an en-bloc lateral resection of a pelvic tumor with sidewall muscle, and/or bone, and/or major nerve, and/or major vascular structure. Post-surgical complications, quality of life (QoL) and survivals were computed. Results Seventy-four women with pelvic isolated relapse were admitted for surgery during the study period. Among them, 8 cases (10.8{\%}) showed lateral isolated relapse involving the iliopsoas muscle and were treated with LEPR. R0 resection was achieved in 6/8 patients (75.0{\%}), while the pathologic margins were microscopically and macroscopically positive in 1 patient (12.5{\%}), respectively. There were no perioperative mortalities. Major postoperative complications occurred in 3 patients (37.5{\%}) through peripheral neuropathies, thrombosis of the vascular graft and compartment syndrome of the leg. Median follow-up time was 21 months (range, 12–28). The 2-year overall survival (OS) was 88{\%} improving up to 100{\%} if R0 resection was achieved. In patients with positive pathologic margins (n = 2), the 2-year OS was 50{\%}. All women showed an improved QoL after surgery. Conclusion LEPR with iliopsoas resection can be safely performed in selected cases with lateral isolated gynecological relapse involving the PSW and was associated with improved QoL and prolonged survival when an R0 resection was achieved.",
keywords = "Iliopsoas resection; Lateral endopelvic resection; Pelvic side wall disease; Recurrent gynecological malignancies; Adult; Aged; Compartment Syndromes; Disease-Free Survival; Female; Graft Occlusion, Vascular; Humans; Middle Aged; Muscle, Skeletal; Neoplasm Recurrence, Local; Ovarian Neoplasms; Pelvic Neoplasms; Peripheral Nervous System Diseases; Postoperative Complications; Psoas Muscles; Quality of Life; Retrospective Studies; Thrombosis; Treatment Outcome; Uterine Neoplasms; Surgery; Oncology",
author = "Vito Chiantera and Anna Fagotti and {Di Giorgio} and Giovanni Scambia and Valerio Gallotta and Tinelli and Giuseppe Vizzielli and {Gueli Alletti}, Salvatore",
year = "2017",
language = "English",
volume = "43",
pages = "710--716",
journal = "European Journal of Surgical Oncology",
issn = "0748-7983",
publisher = "W.B. Saunders Ltd",

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TY - JOUR

T1 - Out-of-the-box pelvic surgery including iliopsoas resection for recurrent gynecological malignancies: Does that make sense? A single-institution case-series

AU - Chiantera, Vito

AU - Fagotti, Anna

AU - Di Giorgio, null

AU - Scambia, Giovanni

AU - Gallotta, Valerio

AU - Tinelli, null

AU - Vizzielli, Giuseppe

AU - Gueli Alletti, Salvatore

PY - 2017

Y1 - 2017

N2 - Objective To report morbidity and oncological outcomes in a consecutive series of lateral isolated recurrent gynecological cancer involving the pelvic side wall (PSW) including the iliopsoas muscle. Material and methods We retrospectively evaluated a consecutive series between 6/2013 and 12/2015 of lateral isolated recurrent gynecological malignancies treated with a lateral endopelvic resection (LEPR). LEPR was defined as an en-bloc lateral resection of a pelvic tumor with sidewall muscle, and/or bone, and/or major nerve, and/or major vascular structure. Post-surgical complications, quality of life (QoL) and survivals were computed. Results Seventy-four women with pelvic isolated relapse were admitted for surgery during the study period. Among them, 8 cases (10.8%) showed lateral isolated relapse involving the iliopsoas muscle and were treated with LEPR. R0 resection was achieved in 6/8 patients (75.0%), while the pathologic margins were microscopically and macroscopically positive in 1 patient (12.5%), respectively. There were no perioperative mortalities. Major postoperative complications occurred in 3 patients (37.5%) through peripheral neuropathies, thrombosis of the vascular graft and compartment syndrome of the leg. Median follow-up time was 21 months (range, 12–28). The 2-year overall survival (OS) was 88% improving up to 100% if R0 resection was achieved. In patients with positive pathologic margins (n = 2), the 2-year OS was 50%. All women showed an improved QoL after surgery. Conclusion LEPR with iliopsoas resection can be safely performed in selected cases with lateral isolated gynecological relapse involving the PSW and was associated with improved QoL and prolonged survival when an R0 resection was achieved.

AB - Objective To report morbidity and oncological outcomes in a consecutive series of lateral isolated recurrent gynecological cancer involving the pelvic side wall (PSW) including the iliopsoas muscle. Material and methods We retrospectively evaluated a consecutive series between 6/2013 and 12/2015 of lateral isolated recurrent gynecological malignancies treated with a lateral endopelvic resection (LEPR). LEPR was defined as an en-bloc lateral resection of a pelvic tumor with sidewall muscle, and/or bone, and/or major nerve, and/or major vascular structure. Post-surgical complications, quality of life (QoL) and survivals were computed. Results Seventy-four women with pelvic isolated relapse were admitted for surgery during the study period. Among them, 8 cases (10.8%) showed lateral isolated relapse involving the iliopsoas muscle and were treated with LEPR. R0 resection was achieved in 6/8 patients (75.0%), while the pathologic margins were microscopically and macroscopically positive in 1 patient (12.5%), respectively. There were no perioperative mortalities. Major postoperative complications occurred in 3 patients (37.5%) through peripheral neuropathies, thrombosis of the vascular graft and compartment syndrome of the leg. Median follow-up time was 21 months (range, 12–28). The 2-year overall survival (OS) was 88% improving up to 100% if R0 resection was achieved. In patients with positive pathologic margins (n = 2), the 2-year OS was 50%. All women showed an improved QoL after surgery. Conclusion LEPR with iliopsoas resection can be safely performed in selected cases with lateral isolated gynecological relapse involving the PSW and was associated with improved QoL and prolonged survival when an R0 resection was achieved.

KW - Iliopsoas resection; Lateral endopelvic resection; Pelvic side wall disease; Recurrent gynecological malignancies; Adult; Aged; Compartment Syndromes; Disease-Free Survival; Female; Graft Occlusion, Vascular; Humans; Middle Aged; Muscle, Skeletal; Neoplas

UR - http://hdl.handle.net/10447/232709

UR - http://www.elsevier.com/inca/publications/store/6/2/3/0/3/3/index.htt

M3 - Article

VL - 43

SP - 710

EP - 716

JO - European Journal of Surgical Oncology

JF - European Journal of Surgical Oncology

SN - 0748-7983

ER -