Pelvic exenteration for locally advanced and recurrent prostate cancer

James Ephraums; Kilian G M Brown; Michael J Solomon; Kirk K S Austin; Peter J Lee; Scott Leslie; Chris Byrne

doi:10.1016/j.ejso.2024.108384

Pelvic exenteration for locally advanced and recurrent prostate cancer

Eur J Surg Oncol. 2024 May 7;50(7):108384. doi: 10.1016/j.ejso.2024.108384. Online ahead of print.

Authors

James Ephraums¹, Kilian G M Brown¹, Michael J Solomon², Kirk K S Austin³, Peter J Lee³, Scott Leslie⁴, Chris Byrne¹

Affiliations

¹ Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, Australia; Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney, Australia; Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital, Sydney, Australia; Faculty of Medicine and Health, Central Clinical School, The University of Sydney, New South Wales, Australia.
² Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, Australia; Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney, Australia; Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital, Sydney, Australia; Faculty of Medicine and Health, Central Clinical School, The University of Sydney, New South Wales, Australia. Electronic address: professor.solomon@sydney.edu.au.
³ Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, Australia; Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney, Australia; Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital, Sydney, Australia.
⁴ Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital, Sydney, Australia; Department of Urology, Royal Prince Alfred Hospital, Sydney, Australia.

PMID: 38749360
DOI: 10.1016/j.ejso.2024.108384

Abstract

Locally advanced or recurrent prostate cancer which invades adjacent pelvic organs, bone or other soft tissue structures is a rare situation. This study aimed to report the outcomes of ten consecutive patients who underwent total pelvic exenteration for prostate cancer at a high-volume specialist centre. Two patients had locally advanced primary tumours, while eight had locally recurrent prostate cancer. Median operating time, blood loss, ICU stay, and hospital stay was 12.2 h (range 9.6-13.8), 2500 ml (500-3000), 4.5 days (2-7) and 36 days (21-78), respectively. There was no inpatient, 30-day, or 90-day mortality. Six patients developed a Clavien-Dindo III complication. R0 resection was achieved in eight patients. Median follow up was 16 months (range 2-77). At last follow up, five patients were alive without disease. These findings suggest that pelvic exenteration for locally advanced and recurrent prostate cancer is safe and represents a potentially curative treatment option for highly selected patients.

Keywords: Pelvic exenteration; Prostate cancer.