Clinical Perspectives


Distant Margins Following Pelvic Exenteration Improve the Survival Rate for Women with Gynecologic Cancer

May 25, 2022

GYN Program Doctors From left, Gynecologic Oncology Program physicians, Mitchel Hoffman, Jing-Yi Chern, Hye Sook Chon, Mian Shahzad and Robert Wenham.

There are certain types of cancer that develop only in the female reproductive system, which include the uterus, fallopian tubes, ovaries, cervix, vagina, and vulva. Collectively known as gynecologic cancers. These tumors exclusively affect patients who are designated female at birth and the standard treatment for gynecologic cancer typically involves surgery.

A pelvic exenteration is a rare and radical surgery used to treat recurrent gynecologic cancers after other treatments have failed and should be performed by surgeons who have expertise in this procedure. This surgery involves the removal of some or all the female reproductive organs. The second stage of the procedure consists of reconstruction, such as a urinary diversion, colostomy, and/or vaginal reconstruction, depending on which organs were removed. The extended surgical resection offers a chance for cure with a five-year survival rate of up to 50%.

Dr. Jing-Yi Chern
Jing-Yi Chern, MD, ScM, Gynecologic Oncology Program
Dr. Robert Wenham
Robert Wenham, MD, MS, FACOG, FACS, Department Chair, Gynecologic Oncology Program

Our gynecologic oncologists, Dr. Jing-Yi Chern and Dr. Robert Wenham of the Gynecologic Oncology Program at Moffitt Cancer Center conducted a study on the margin of survival after pelvic exenteration. The article was recently published in the Gynecologic Oncology publication. This was a retrospective study of 139 women with various gynecologic cancers who underwent pelvic exenteration. It involved analyzing the baseline characteristics, surgical details, postoperative complications, adjuvant therapy, and recurrence/survival outcomes.

The study concluded that patients with distant margins following pelvic exenteration have improved the overall survival rate by 111 months when compared to close margins (32 months). The study indicated that patients with close margins may not need postoperative therapy as it did not change outcomes. Additional studies may need to be performed to further investigate the utility of additional intraoperative therapy to improve outcomes.

If you have a patient who is diagnosed with gynecologic cancer, she may benefit from seeing a gynecologic oncologist at Moffitt early on her diagnosis to ensure the best chance of survival. We offer a wide range of treatment options including pelvic exenteration performed by fellowship-trained surgeons. No matter what type of therapy your patient pursues at Moffitt, our multispecialty team will continually monitor her progress and adjust her treatment plan as necessary to ensure the best possible outcome and quality of life.

For the convenience of our patients and their referring physicians, all our gynecologic oncology services are available through a single program. Additionally, we prioritize short referral times to ensure that our patients can promptly receive the care they need and deserve.

If you’d like to refer a patient to Moffitt, complete our online form or contact a physician liaison for assistance. As part of our efforts to shorten referral times as much as possible, online referrals are typically responded to within 24 - 48 hours.