Summary of Program
Pelvic exenteration is a highly complex surgical procedure performed in selected patients presenting with locally advanced or recurrent pelvic malignancies. From January 1994 to February 2024, over 1100 pelvic exenteration procedures have been performed at RPAH, which is the largest cohort of patients treated by a single institution worldwide. This has led to international recognition of RPAH being highly regarded for its novel multidisciplinary approach, expertise, innovation in surgical techniques, outstanding patient outcomes, and high quality scientific output.
The Pelvic Exenteration research program has developed two main databases that collect surgical outcomes (PESQI) and patient-reported outcomes (QOLPE) of all patients undergoing surgery at RPAH. Patients are followed from baseline (time before surgery) to 5 years postoperative with several measures, including quality of life outcomes. The program continues to evolve with over 40 studies currently being conducted incorporating topics of surgical techniques, surgical outcomes, survival, decision-making, quality of life, nutrition, depression, anxiety, stress, physical activity, 3D printing and cost. In addition, the Pelvic Exenteration team was successful in receiving a competitive grant from the National Health and Medical Research Council. The team also published 19 peer-reviewed research manuscripts in national and international journals during this reporting period.
Highlights
- The 1000th pelvic exenteration was performed in July 2022. This is an amazing milestone for the program and will be the first single centre in the world to perform such an amount of pelvic exenterations. Data from these patients are entered into our surgical registry, which includes detailed patient characteristics and surgical outcomes.
- Of the over 1100 pelvic exenteration surgeries performed at RPAH, over 780 of these patients consented to participate in the long-running study titled ‘Quality of Life in patients following pelvic exenteration surgery’, since the beginning of this prospective cohort study in 2008. This study was initially funded by Cancer Australia and the Cancer Council Australia through the Priority-driven Collaborative Cancer Research Scheme. Currently, quality of life and other patient-reported outcomes are collected at 9 distinct time points from baseline (before surgery) to 5 years postoperatively.
- The RPAH Pelvic Exenteration program is a member of the PelvEx Collaborative. PelvEx is an international collaborative group involving >140 units across the world with the aim to explore outcomes following pelvic exenteration. Recently, SOuRCe has completed an international benchmarking. This benchmark analysis has demonstrated that patients undergoing pelvic exenteration surgery at RPAH underwent more complex procedures including wider resections of bony pelvis, resulting in increased surgical times and postoperative recovery, but most importantly, achieved higher rates of clear resection margins (R0), lower 30-day mortality and superior survival outcomes. These results are a credit to the large group of multi-disciplinary staff involved in the delivery of the RPAH Pelvic Exenteration Surgical Program.
If you would like to get involved with our Pelvic Exenteration Research Program, submit an expression of interest HERE.