Materials and methods: From September 2021 to December 2022, 23 PE were performed, including 12 total and 11 anterior. The mean age was 52.2±10.0 years (range 39-83 years). All patients were diagnosed with locally advanced recurrent cervical cancer: 7 (30%) with stage II, 8 (35%) with stage III, and 8 (35%) with stage IV according to the TNM classification. Histologically, cervical cancer was represented by moderately differentiated squamous cell carcinoma. PE was preceded by the following treatments: neoadjuvant chemotherapy in 17 (74%) patients, surgical treatment in 4 (17%) patients and chemoradiotherapy in 2 (9%) patients. More than half (56%) of patients achieved grade 2 therapeutic pathomorphism. The advanced disease involved the following adjacent organs: bladder - 16 (70%), intestines - 13 (56%), endometrium - 7 (30%), myometrium and parametrium - 4 (17%), fallopian tubes, vagina, and ovary – 2 (9%). 

Results: The average follow-up time for patients was 9.4±8.8 months. Median time to progression – 8.7 months [5.9; 10.8]. During the observation period, 78.3% (18/23) of patients died. Progression was recorded in 39.1% (9/23) of patients. The 1-year overall survival of patients was 38.7% (median 8.9 months). The 1-year tumor-specific survival rate was 60.6% (median 14.1 months). The 1- and 3- year progression-free survival (PFS) rates were 63.0% and 49.0% (median, 13.4 months), respectively. 

Conclusion: During the observation period, death occurred in 54.6% (12/23) of cases in the anterior PE group, and in 25% (6/23) in the total group. The median overall survival with anterior PE is 2 times higher compared to total PE (9.6 months versus 4.1 months). Median PFS was 13.4 months. For patients after anterior and total pelvic exenteration, 1-year PFS was 51.9±17.6 and 72.9±13.5; 3-year – 25.9±15.7 and 72.9±13.5 (p=0.178), respectively. Thus, PE is justified and significantly expands the possibilities of surgical treatment.

Gulnoz Khakimova, MD, PhD, is a medical oncologist from Uzbekistan. She graduated with honors from the Tashkent Pediatric Medical Institute in 2015 and continued her training at the N.N. Blokhin National Medical Oncology Center in Moscow, completing residency and defending her PhD in oncology (2017–2020). In 2022, she obtained the ESO Certificate of Advanced Studies in Gastrointestinal Cancer. Since 2020, Dr. Khakimova has been working at the Republican Specialized Scientific-Practical Medical Center of Oncology and Radiology in Tashkent, where she focuses on chemotherapy for solid tumors. She also serves as an Assistant in the Department of Oncology at the Tashkent Pediatric Medical Institute and practices at the Nano Medical Clinic.Her clinical and research interests include gastrointestinal, breast, and gynecological cancers, perioperative systemic therapy, and the role of immunotherapy in solid tumors. She is the author and co-author of more than 60 scientific publications and has presented at national and international oncology meetings. Dr. Khakimova has actively participated in numerous ESMO educational programs, including preceptorships and congresses, as well as OMI Salzburg seminars. She is a member of ESMO, ASCO, AACR, ESTRO, and RUSSCO. She continues to combine clinical work, teaching, and research with the goal of improving cancer care in Central Asia.