Imaging in pelvic exenteration—a multidisciplinary practice guide from the ESGAR-SAR-ESUR-PelvEx collaborative group
Pelvic exenteration (PE) is a radical surgical approach designed for the curative treatment of advanced pelvic malignancies, requiring en-bloc resection of multiple pelvic organs. While the procedure is radical, it has shown promise in enhancing long-term survival and is now comparable in surgical mortality to elective resections for primary pelvic cancers. Imaging plays a crucial role in preoperative planning, with MRI, CT, and PET/CT being pivotal in assessing the extent of cancer and formulating a surgical roadmap. This paper presents clinical practice guidelines for imaging in the context of PE, developed jointly by ESGAR, SAR, ESUR, and the PelvEx Collaborative. These guidelines aim to standardize imaging protocols and reporting to improve the preoperative assessment and facilitate decision-making in the multidisciplinary treatment of pelvic cancers. Our recommendations underscore the importance of a multidisciplinary approach and the need for clear and precise imaging reports to optimize patient care. CLINICAL RELEVANCE STATEMENT: Our recommendations underscore the importance of a multidisciplinary approach and the need for clear and precise imaging reports to optimize patient care. KEY POINTS: MRI is mandatory for local staging in pelvic exenteration. Structured reporting (using the template provided in this guide) is recommended. Multidisciplinary review of imaging is critical for surgical planning.
Authors
- Doenja M. J. Lambregts (ORCID: https://orcid.org/0000-0003-2990-0099)
- Yulia Lakhman (ORCID: https://orcid.org/0000-0003-3626-4502)
- David Burling (ORCID: https://orcid.org/0000-0002-8897-877X)
- Maria Antonietta Gambacorta (ORCID: https://orcid.org/0000-0001-5455-8737)
- Atul B. Shinagare (ORCID: https://orcid.org/0000-0003-0273-7359)
- Stéphanie Nougaret (ORCID: https://orcid.org/0000-0002-6398-8648)
- Ann H. Klopp (ORCID: https://orcid.org/0000-0002-2081-0735)
- Aaron Quyn (ORCID: https://orcid.org/0000-0002-4333-5658)
- Iva Petkovska (ORCID: https://orcid.org/0000-0002-4373-6494)
- Lennart Blomqvist (ORCID: https://orcid.org/0000-0003-1716-2439)
- Rosemarie Forstner (ORCID: https://orcid.org/0000-0003-0362-5965)
- R. Manfredi (ORCID: https://orcid.org/0000-0002-8552-6276)
- Aradhana M. Venkatesan (ORCID: https://orcid.org/0000-0002-5033-0820)
- Quentin Denost (ORCID: https://orcid.org/0000-0003-3088-5244)
- Damian Tolan (ORCID: https://orcid.org/0000-0001-9895-9874)
- James A. Stephenson (ORCID: https://orcid.org/0000-0001-5649-6322)
- Geerard L. Beets (ORCID: https://orcid.org/0000-0002-1671-9912)
- Katherine E. Maturen (ORCID: https://orcid.org/0000-0002-7357-4529)
- Luca Russo (ORCID: https://orcid.org/0000-0003-1717-8676)
- Benedetta Gui
Institutions
- Brigham and Women's Hospital (US)
- Memorial Sloan Kettering Cancer Center (US)
- Karolinska University Hospital (SE)
- University College London Hospitals NHS Foundation Trust (GB)
- The University of Texas MD Anderson Cancer Center (US)
- Harvard University (US)
- University of Michigan (US)
- Leeds Teaching Hospitals NHS Trust (GB)
- London North West Healthcare NHS Trust (GB)
- St James's University Hospital (GB)
- Agostino Gemelli University Polyclinic (IT)
- Karolinska Institutet (SE)
- The Netherlands Cancer Institute (NL)
- Oncode Institute (NL)
- Dana-Farber Cancer Institute (US)
- Services déconcentrés d'appui à la recherche Occitanie-Montpellier (FR)
- Istituti di Ricovero e Cura a Carattere Scientifico (IT)
- St Mark's Hospital (GB)
- Dana-Farber Brigham Cancer Center (US)
- University College London (GB)
Publication Details
- Journal
- European Radiology
- Published
- 2024-08-25
- DOI
- https://doi.org/10.1007/s00330-024-10940-z
- Citations
- 14
- Primary Topic
- Colorectal Cancer Surgical Treatments
- Type
- article
- Field-Weighted Citation Impact
- 3.96