LAUSR

Local vascular invasion of advanced pelvic malignancy has previously been regarded as a relative or absolute contraindication to surgical resection. To achieve an R0, the implementation of oncovascular techniques is necessary. The evidence base for the role and outcomes of oncovascular procedures in this context is not well established. This systematic review aims to synthesise the current literature on outcomes in oncovascular resection in advanced pelvic cancer across all tumour types. A systematic review was performed according to a pre-defined protocol (PROSPERO ID:42024613055). MEDLINE, EMBASE, Cochrane Library, and Web of Science electronic databases were interrogated between January 1, 1947, to January 1, 2024. All studies that explored oncovasular resection in advanced pelvic cancer were considered. The search returned 886 articles. 681 were reviewed leaving 59 articles for full assessment. 16 studies were included in the final data synthesis, including 533 patients [M:54%,F:46%] with a median age of 53 years [20-80]. 57% (n=306) were recurrent cancers, with the majority being colorectal in origin. Overall, R0 resection rate, independent of tumour type, was 65% (n=218) in procedures with curative intent. Recurrence rates ranged between 13-86% and mortality rates 13-65% over median follow up periods of 12-72 months. 22% (n=117) suffered a significant complication (>Clavien-Dindo grade III). Patient reported outcomes were collected in 6% (n=36) of cases. R0 resection is achieved in two thirds of patients undergoing oncovascular resection for advanced pelvic malignancy with curative intent but with significant morbidity and high recurrence rates reported. Patient reported outcomes are largely absent.