Talk:Pelvic exenteration

Female biased POV
This procedure may be applied to men as well as women, yet the article pertains only to this procedure in women. --Una Smith (talk) 20:02, 27 April 2008 (UTC)


 * I have expanded the POV but details re the procedure in men are scant and probably misleading. --Una Smith (talk) 20:17, 27 April 2008 (UTC)

A controversial procedure?
With regard to this edit: IMHO, it is a mischaracterization to say that pelvic exenterations are controversial -- in well-selected patients. The surgery is done in locally advanced cancers or recurrent ones without widely metastatic disease, as a sort of hail mary. In other words, in selected individuals it is chance for a cure and does result in a cure in a subset of individuals.

The observational studies show some modest benefit. A controlled trial would probably be hard to justify given the observational data.

This is the best paper I've found on the topic: http://www.ncbi.nlm.nih.gov/pubmed/7502599

Other papers: http://www.ncbi.nlm.nih.gov/pubmed/17406945 http://www.ncbi.nlm.nih.gov/pubmed/12022371 http://www.ncbi.nlm.nih.gov/pubmed/17406945 http://www.ncbi.nlm.nih.gov/pubmed/22107085 http://www.ncbi.nlm.nih.gov/pubmed/21939606

Nephron T|C 20:03, 27 March 2012 (UTC)


 * I don't know. The Hagmueller abstract doesn't give P values for the comparisons. Are those differences in 5-year survival statistically significant? What does "curative" mean for T4 colorectal cancer? Are there any quality of life measures?


 * But that's not the issue. I don't want to do WP:OR. Barron Lerner is a highly-published academic, The NYT is a WP:RS (although not a formal medical source). This procedure is justified on the basis of current opinion, not high-quality evidence, and Lerner's opinion is legitimate. This is something that medical ethicists talk about.


 * This isn't a cause for me. I'm not ready to do a lot of research to defend it. I just added it because it seems to be a classic example that doctors give of overly aggressive surgery. I'd like to have more than one source to support Lerner, and I'd like to see a more detailed discussion of the controversy. But I think a short mention is better than nothing.


 * It might be appropriate to say that it's controversial, but several recent studies report a survival benefit.


 * Anyway, thanks for the courtesy of alerting me to the edit. --Nbauman (talk) 04:18, 28 March 2012 (UTC)