Modified posterior pelvic exenteration for advanced ovarian cancer: ten-year experience in 17 resectable cases

Objective: To assess safety, efficacy and impact on survival of low anterior en bloc resection (modified posterior pelvic exenteration) as part of optimal debulking for primary advanced ovarian cancer. Methods: Complete follow-up data were available for 17 patients who underwent this surgical procedure for advanced ovarian cancer between January 1996 and June 2006. The median age was 58 years (24 to 77). All had epithelial cancer. Seven patients underwent primary debulking, and ten patients underwent interval debulking. All patients underwent optimal cytoreduction (less than 1 cm residual disease) and received postoperative platinum-based chemotherapy. Rresults: The postoperative mortality was 0%, while the overall major morbidity was 23.52% (n = 4). Residual disease after debulking was less than 1 cm in four patients, and was microscopic in 13 patients. The overall three-year survival rate was 76.47%, and the median survival time was 32 months. Cconclusions: When necessary, low anterior en bloc resection (modified posterior pelvic exenteration) should not be an obstacle against optimal surgery. The morbidity rate was high, but the mortality rate was 0%. Long-term survival may ensue from this approach.