Genitourinary tract preservation versus pelvic exenteration for advanced XXXX .

@entity1 @entity5 @entity14
INTRODUCTION: Total pelvic exenteration (TPE) is the standard of care for locally advanced @entity14 . This is a morbid procedure often leaving the @entity1 with two ostomy sites and an extended recovery. Bladder preservation with complete @entity5 resection is often possible in these cases and we set out to determine if limited resection of the GU tract was as effective in @entity5 control as TPE. MATERIALS AND METHODS: This is a retrospective review of all @entity1 over a 7-year period with @entity14 invading the urinary system. These @entity1 were divided into two groups based upon the surgical procedure they received: TPE or GU tract sparing surgery. @entity5 stage, adjuvant @entity5 therapy, and complications were reviewed. Recurrence and survival rates were calculated. RESULTS: There were 19 @entity1 with @entity14 invading the GU tract. Eight @entity1 were treated with TPE and 11 @entity1 received GU tract sparing procedures. @entity5 stage and extent of disease were similar for both groups as were adjuvant/neoadjuvant therapy received. The average follow up from surgery for TPE and GU tract sparing procedures was 40 months (range 9 - 96) and 53 months (range 21.5 - 94), respectively. The limited resection and TPE groups experienced similar complication rates: 7/11 (63.6%) and 6/8 (75%) respectively. The 5-year survival rate was 37.5% and 61.4% for TPE and limited GU resections, respectively (p=0.07). CONCLUSION: The @entity5 recurrence and complication rates were similar in both groups offering no clear advantage to TPE. GU sparing surgery in the face of locally invasive @entity14 is a viable option allowing for treatment of the disease and reducing the morbidity of total pelvic exenteration.
