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Session: ePoster: Colon and Colorectal Cancer 22 (Sat315)

EP130 - Prognosis utilizing the Modified Pecking classification for female patients undergoing posterior pelvic exenteration for locally advanced rectal cancer

Saturday, May 10, 2025
3:53 PM – 3:58 PM PT
Location: Monitor 4, Sails Pavilion, Upper Level

    ePoster Presenter(s)

  • Akash Mor, MS, MCh

    Trainee, Division of Colorectal Surgery , Department of Surgical oncology
    Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai , India
    Aurangabad, Maharashtra, India

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • sa

    shahin krishna amroskar, n/a

    Senior Resident, Mch Surgical oncology
    Tata Memorial Centre Mumbai
    Mumbai, Maharashtra, India

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • AS

    ANKIT SHARMA, MBBS, MS, MCH

    ASSISTANT PROFESSOR
    TATA MEMORIAL HOSPITAL, MUMBAI
    Tata Memorial Hospital, Mumbai
    MUMBAI, Maharashtra, India

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • MK

    MUFADDAL K. KAZI, MBBS, MS, MCH

    Associate Professor
    Tata memorial hospital, Mumbai
    Mumbai, Maharashtra, India

    Disclosure information not submitted.

  • AD

    ASHWIN DESOUZA, MBBS, MS, MCh

    Professor
    Tata Memorial Center, Mumbai
    Mumbai, Maharashtra, India

    Disclosure information not submitted.

    • Senior Author(s)

  • Avanish P. Saklani, Tata memorial Hospital, Homi Bhabha National Institute, Mumbai

    Professor
    Division of colorectal Surgeon, Department of Surgical oncology
    Tata Memorial hospital , Mumbai
    Mumbai, Maharashtra, India

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.
Akash Mor, MS, MCh: This individual has no financial relationships with ineligible companies.
shahin krishna amroskar, n/a, N/A: This individual has no financial relationships with ineligible companies.
ANKIT SHARMA, MBBS, MS, MCH: This individual has no financial relationships with ineligible companies.
Avanish P. Saklani, Tata memorial Hospital, Homi Bhabha National Institute, Mumbai: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: The China PelvEX cooperation has recently detailed the prognosis of posterior pelvic exenteration using the Pecking classification. In order to demonstrate variations in presentation and prognosis when compared to other populations, we have looked into the same in the Indian population.Additionally, we made an effort to confirm Pecking classification as a survivor outcome predictor. Our classification for Pecking type IV is IVa, which includes major vaginal wall excision and reconstruction in addition to posterior exenteration, and IVb, which includes major vaginal wall excision and reconstruction.

Methods/Interventions: This is a retrospective analysis of a prospectively collected database of patients treated between 2015 and 2023 with posterior pelvic exenteration (PPE). A total of 161  patients were found to be classified as PPE-I (17), PPE-II (23), PPE-III (70), PPE-IVa (14), and PPE-IVb (37). Analysis was done on survival, oncological, and short-term results.

Results/Outcomes: 161 patients  were included and analyzed. PPE-I (17), PPE-II (23), PPE-III (70), PPE-IVa (14), and PPE-IVb (37) were classified according to Pecking classification. In PPE-IVa (37.5%), hospital complication rates were greater than in PPE-IVb (19%), PPE I (17.64%), PPE III (12.85%), and PPE II (8.69%). PPE-I, PPE-II, PPE-III, PPE-IVa, and IVb had R0 resection rates of 100%, 95.61%, 95.71%, 100%, and 93%, respectively. PPE IVa (12.5%), PPE-III (8.57%), PPE-I (5.88%), PPE-II (4.16%), and PPE IVb (2.38%) had greater rates of locoregional recurrence. As locoregional recurrence rate was low, loco regional recurrence free survival was not valid. PPE-I, PPE-II, PPE-III, PPE-IVa, PPE-IVb, and 85%, 67%, 73%, 47.5% and 73.9% were the three-year OS values. PPE-I, PPE-II, PPE-III, PPE-IVa, PPE-IVb, and PPE-IVb had 3-year DFSs of 73.9%, 71%, 80 %, 71%, and 69% respectively. Node positivity (mesolectal and lateral) is an independent predictor of OS and DFS on univariable analysis. Furthermore, EMVI functions as a separate predictor of OS. The survival function cannot be predicted by the pecking classification.

Conclusion/Discussion: Pecking classification showed that patients undergoing posterior pelvic exenteration with locally advanced rectal cancer had a distinct Surgical outcome. Pecking categorisation did not show significant difference in survival in the Indian population. Pecking classification is not a predictor of survival function. Pecking classification may need long term follow up to have more loco-regional event to yield significant difference.