WP 2.6: Palliative Pelvic Exenteration for Alleviating Symptoms in Cancer Patients

Pelvic exenteration (PE) is the only curable treatment option in patients with locally advanced or recurrent cancer, of various origins, invading surrounding organs or structures in the pelvis. The main indication for PE is the ability to achieve oncological radicality with tumour-free resection margins (R0). Especially, the improvement in reconstruction has made it possible to remove more tissue if necessary.
The mortality after pelvic exenteration is low; 0.5% to 2%. However, despite marked modifications in the surgical techniques, improved technology, and improvements in the perioperative care, the 30-day morbidity is still reported high, ranging from 31.2% to 45.1% for rectal cancer.

While the indication for PE with curative intent is clear, there is no clear indications in cases where symptom alleviation may be the primary goal. For instance, if the symptom burden may be so heavy that PE should be considered, even though non-radical or in case of metastases that are either non-resectable or multiple.
The objective of this study is to evaluate the QoL before and after PE performed to alleviate symptoms as the main indication.
Further, to identify potential preoperative parameters predicting improved QoL to support the selection of future patients for PE on the indication to alleviate symptoms.
Additionally, to perform an economic evaluation of an alleviating pelvic exenteration.
The study will, thus, provide new and comprehensive knowledge regarding the decision-making on when to perform an alleviating PE as well as provide information on health economical evaluation related to alleviating PE and the patient’s QoL.

Awarded to: Jonas Amstrup Funder (vejle Sygehus) – CFA2

Awarded grant to support TAP personnel.