Background and Objectives: Pelvic tumors are often large and difficult to e
xcise with appropriate surgical margins due to their size, proximity to neu
rovascular structures, and major intraoperative bleeding. The purpose of th
is study is to evaluate the yield of preoperative angiography and embolizat
ion so as to facilitate achievement of good surgical results.
Methods: Eighteen patients who suffered from large pelvic tumors (average s
ize, 10.7 cm x 8.3 cm x 3.7 cm), 15 primary and 3 metastatic, underwent sur
gery at our institution between 1990 and 1995, after preoperative angiograp
hy and embolization of the tumors.
Results: The efficacy of the procedure was high. In all but one patient, th
e grade of vascularity of the tumor was reduced by at least two levels (bas
ed on our new tumor vascularity scale. In most patients, appropriate surgic
al margins were achieved. The average perioperative blood loss was only 750
cc. Procedure-associated complications were negligible.
Conclusions: The results of this study call for the use of angiography and
embolization in the management of patients with large pelvic tumors. J. Sur
g. Oncol. 1999:70:41-44. (C) 1999 Wiley-Liss, Inc.