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Summary Box

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 A patient’s general physical condition is the most important determinant of postoperative complications.

 CPET is a reliable preoperative indicator, highlighting those at risk of surgical stress.

 Preoperative optimization involves a multidisciplinary team of surgeons, anesthesiologists, physiotherapists, stoma therapists, and dieticians.

 A minimum of seven days of preoperative nutritional support providing at least 10 kcal/kg/day is considered adequate for patients who are nutritionally at risk.

 Preoperative stoma education, correction of anemia, and psychological support have a positive impact on postoperative quality of life.

 Patients undergoing pelvic exenteration should receive extended VTE prophylaxis.

Surgical Management of Advanced Pelvic Cancer

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