Abstract

Background: Recurrent cervical cancer following radiotherapy and/or chemotherapy is often associated with poor prognosis. While chemotherapy primarily serves a palliative role, pelvic exenteration (PE) is considered the definitive salvage treatment for patients with locally recurrent or persistent disease. Despite its high risk of postoperative complications, PE has been shown to significantly improve patient outcomes. However, data on its efficacy in Vietnam remains limited. This study aims to evaluate safety, efficacy and recurrence outcomes of implementing pelvic exenteration in patients with recurrent cervical cancer.

Methods: A retrospective cohort study involving patients with recurrent cervical cancer undergoing pelvic exenteration at Ho Chi Minh City Oncology Hospital from October 2022 to May 2025.

Result: A total of 34 patients underwent PE for recurrent cervical cancer. Among them, 76.47% underwent total exenteration, 17.65% anterior exenteration, and 5.88% posterior exenteration. The median operative duration was 195 minutes, with a mean blood loss of 561.76 mL. R0 resection was achieved in 82.35% of cases. Early and late postoperative complications occurred in 35.29% and 55.88% of patients, respectively, with no early postoperative mortality. Empty pelvis syndrome was reported in 41.18% of the patients. In the curative intent group, the patients were followed on 2–24 months. The recurrence and mortality rates were 28.57% (8 cases) and 39.29% (11 cases), respectively. The 1-year DFS rate was 55.7% (95% CI: 36.0–86.1%), and the 1-year OS rate was 55.6% (95% CI: 37.5–82.5%).

Conclusion: The study’s outcomes emphasize the safety and feasibility of employing PE in recurrent cervical cancer patients, with an acceptable complication rate and encouraging early outcomes. Although the recurrence rate following PE remains a concern, preliminary outcomes suggest that this procedure may offer a survival benefit in selected patients.