Multidisciplinary approach to pelvic tumoral masses

The aim of this study is to examine the results of the multidisciplinary approach in the patients operated on for pelvic masses at our centre and to develop a tumour complexity score, to investigate the power of this score in determining surgical and final oncological outcomes, and to bring the score into clinical prognostic and predictive use. The clinicopathological data set of 121 patients who were examined for pelvic mass in our centre between January 2005 and January 2020 were prospectively collected. Twenty-one patients who did not meet the inclusion criteria were excluded. The ''PElvic TUmour COMplexity'' score (PETCOM) was defined by combining the radiological evaluation and perioperative surgical criteria. The PETCOM score was calculated for each patient. Logistic regression analysis was performed with other clinicopathological data. The cut-off point of PETCOM score was determined with ROC analysis and two subgroups were defined: patients with low PETCOM score and high PETCOM score. The survival outcomes were compared for all the patient groups. In the univariate analyse, it was found that PETCOM score established a significant difference for mortality (p <0.001), local recurrence (p = 0.002) and distant metastasis (p = 0.010). In multivariate analyse, the PETCOM score was found to be a strong independent prognostic factor for mortality (p = 0.022), local recurrence (p = 0.004), and distant metastasis (p = 0.007). The survival time of patients with low and high PETCOM scores was evaluated by Kaplan-Meier statistical analysis. A statistically strong significant difference was found between the mean survival times of patients with low PETCOM (138.62 ± 13.05 months) and high PETCOM (62.53 ± 9.25 months) scores (p <0.001). It was found that PETCOM score made a significant difference for mortality (p = 0.013), morbidity (p = 0.001), local recurrence (p = 0.047), pelvic specific complications (p = 0.017) in the malignant patient group. In this study, PETCOM scoring system was found to be a strong prognostic factor to determine surgical morbidity and all final oncologic outcomes. The PETCOM score has proven to be an effective scoring system in order to improve diagnosis and treatment results, to increase patient quality of life, and to compare different centres' experiences. Key Words: Pelvic mass, Pelvic cancer, Presacral mass, Complexity, Score