Adjuvant Chemotherapy and Survival After Pelvic Exenteration for Gynecologic Cancers in the COREPEX Study - Summary - MDSpire

Adjuvant Chemotherapy and Survival After Pelvic Exenteration for Gynecologic Cancers in the COREPEX Study

  • By

  • Nicolò Bizzarri

  • Zoltan Novák

  • Giulio Ricotta

  • Mihai Emil Cãpîlna

  • Diana Giannarelli

  • Santiago Domingo

  • Vito Chiantera

  • Hüseyin Akıllı

  • David Cibula

  • Diana Zach

  • Andrea Miranda

  • Porfyrios Korompelis

  • Enrique Chacon

  • Ignacio Zapardiel

  • Björn Lampe

  • Valentyn Svintsitskyi

  • Olga Matylevich

  • Gabrielle H. van Ramshorst

  • Cagatay Taskiran

  • Fuat Demirkıran

  • Tibor Lengyel

  • Giuseppe Vizzielli

  • Matteo Loverro

  • Francesco Fanfani

  • Claudia Marchetti

  • Gwenael Ferron

  • Alejandra Martinez

  • Elodie Gauroy

  • Emmanuel Ladanyi

  • Leo Szilard Kiss

  • Victor Lago

  • Manel Montesinos-Albert

  • Mariano Catello Di Donna

  • Giuseppe Cucinella

  • Jiri Slama

  • Viktória Rosta

  • Mustafa Zelal Muallem

  • Ali Kucukmetin

  • Anna Fagotti

  • Sahar Salehi

  • Denis Querleu

  • June 26, 2026

  • 0 min

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Objective:

To investigate the association of adjuvant chemotherapy with overall, disease-free, and cancer-specific survival in patients undergoing pelvic exenteration with pelvic lymph node metastasis.

Approach:
  • Study Design: Secondary analysis of the COREPEX study, including patients with cervical, vaginal, vulvar, or endometrial cancer who underwent pelvic exenteration between January 1, 2005, and March 31, 2023.
  • Patient Stratification: Patients were stratified based on the administration of adjuvant chemotherapy.
  • Data Analysis: Data analyzed using SPSS and R, with statistical significance set at P <.05.
Key Findings:
  • Patients receiving adjuvant chemotherapy had significantly better median disease-free survival (DFS) of 20 months (95% CI, 10.7-29.3) versus 7 months (95% CI, 3.5-10.5) (P =.001).
  • Overall survival (OS) was also significantly better in the chemotherapy group, with a median of 28 months (95% CI, 22.4-33.5) compared to 10 months (95% CI, 6.6-13.4) (P <.001).
  • Cancer-specific survival (CSS) was improved in the chemotherapy group, with a median of 28 months (95% CI, 22.6-33.4) versus 13 months (95% CI, 8.0-18.0) (P =.001).
  • Multivariable analysis indicated adjuvant chemotherapy as the only independent factor associated with improved DFS (HR, 0.44 [95% CI, 0.27-0.71]) and OS (HR, 0.39 [95% CI, 0.23-0.66]).
Interpretation:

Adjuvant chemotherapy is associated with improved survival outcomes in patients undergoing pelvic exenteration for gynecologic cancers with metastatic pelvic lymph nodes.

Limitations:
  • Retrospective nature of the study.
  • Heterogeneity in chemotherapy regimens.
  • Lack of immunotherapy data due to its unavailability during the study period.
  • No information on chemotherapy toxicity.
  • Some patients were not fit for chemotherapy due to poor postoperative condition.
Conclusion:

Administration of adjuvant chemotherapy was associated with improved survival in this patient population.

Original Source(s)

Adjuvant Chemotherapy and Survival After Pelvic Exenteration for Gynecologic Cancers in the COREPEX Study

  • by Nicolò Bizzarri, Zoltan Novák, Giulio Ricotta, Mihai Emil Cãpîlna, Diana Giannarelli, Santiago Domingo, Vito Chiantera, Hüseyin Akıllı, David Cibula, Diana Zach, Andrea Miranda, Porfyrios Korompelis, Enrique Chacon, Ignacio Zapardiel, Björn Lampe, Valentyn Svintsitskyi, Olga Matylevich, Gabrielle H. van Ramshorst, Cagatay Taskiran, Fuat Demirkıran, Tibor Lengyel, Giuseppe Vizzielli, Matteo Loverro, Francesco Fanfani, Claudia Marchetti, Gwenael Ferron, Alejandra Martinez, Elodie Gauroy, Emmanuel Ladanyi, Leo Szilard Kiss, Victor Lago, Manel Montesinos-Albert, Mariano Catello Di Donna, Giuseppe Cucinella, Jiri Slama, Viktória Rosta, Mustafa Zelal Muallem, Ali Kucukmetin, Anna Fagotti, Sahar Salehi, Denis Querleu

  • June 26, 2026

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