{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T12:17:20Z","timestamp":1769257040811,"version":"3.49.0"},"reference-count":24,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T00:00:00Z","timestamp":1727654400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100018063","name":"Bowel Research UK","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100018063","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psycho-Oncology"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The empty pelvis syndrome (EPS) is common after pelvic exenteration (PE), causing fluid collections, bowel obstruction, perineal sinuses, and fistulas. The best approach to fill the pelvis to mitigate this remains controversial, and the impact of EPS on health\u2010related quality of life (HrQoL) is unknown. This study is the first to begin to explore lived\u2010experiences of EPS complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Unstructured EPS virtual focus group meetings were conducted with a convenience sample of patients who underwent PE, as an extension of a modified\u2010Delphi study. Interpretative phenomenological analysis was conducted on verbatim transcripts to generate group experiential themes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twelve patients (eight UK, one Dutch, and three Belgian) participated in four focus groups. Eight EPS complications were reported, (two pelvic collections, five chronic perineal sinuses, and one bowel obstruction). Group experiential themes were <jats:italic>\u2018Out of Options\u2019<\/jats:italic>, depicting patients forced to accept complications or limited survival; <jats:italic>\u2018The New Normal\u2019<\/jats:italic>, with EPS potentially delaying adaptation to post\u2010PE HrQoL; <jats:italic>\u2018Information Influencing Adaptation,\u2019<\/jats:italic> emphasising the significance of patients understanding EPS to cope with its effects; and <jats:italic>\u2018Symptoms,\u2019<\/jats:italic> reporting manifestations of EPS, the resultant physical limitations, and an intangible feeling that patients lost part of themselves.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>EPS may influence patient decision\u2010making, regret, adaptation, and information\u2010seeking. It can cause a variety of unpleasant symptoms and physical limitations, which may include phantom phenomenon. This work supports ongoing purposeful HrQoL research to better define these themes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pon.9316","type":"journal-article","created":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T02:49:02Z","timestamp":1727750942000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A Preliminary Phenomenological Exploration of Experiences of the Empty Pelvis Syndrome Derived From a Modified\u2010Delphi: The Price of Survival Following Pelvic Exenteration for Advanced Pelvic Cancer"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3602-0065","authenticated-orcid":false,"given":"Charles T.","family":"West","sequence":"first","affiliation":[{"name":"Cancer Sciences University of Southampton  Southampton UK"},{"name":"Southampton Complex Cancer and Exenteration Team  Southampton UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Denys","sequence":"additional","affiliation":[{"name":"Ghent University  Ghent Belgium"},{"name":"Ghent University Hospital  Ghent Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sam A.","family":"Rose","sequence":"additional","affiliation":[{"name":"Bowel Research UK  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva","family":"Pape","sequence":"additional","affiliation":[{"name":"Ghent University  Ghent Belgium"},{"name":"Ghent University Hospital  Ghent Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabrielle H.","family":"van Ramshorst","sequence":"additional","affiliation":[{"name":"Ghent University  Ghent Belgium"},{"name":"Ghent University Hospital  Ghent Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul A.","family":"Sutton","sequence":"additional","affiliation":[{"name":"Colorectal and Peritoneal Oncology Centre The Christie Hospital  Manchester UK"},{"name":"Division of Cancer Sciences University of Manchester  Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideaki","family":"Yano","sequence":"additional","affiliation":[{"name":"Southampton Complex Cancer and Exenteration Team  Southampton UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Malcolm A.","family":"West","sequence":"additional","affiliation":[{"name":"Cancer Sciences University of Southampton  Southampton UK"},{"name":"Southampton Complex Cancer and Exenteration Team  Southampton UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex H.","family":"Mirnezami","sequence":"additional","affiliation":[{"name":"Cancer Sciences University of Southampton  Southampton UK"},{"name":"Southampton Complex Cancer and Exenteration Team  Southampton UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lynn","family":"Calman","sequence":"additional","affiliation":[{"name":"Health Sciences University of Southampton  Southampton UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samantha C.","family":"Sodergren","sequence":"additional","affiliation":[{"name":"Health Sciences University of Southampton  Southampton UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,9,30]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.6699"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000003533"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002528"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjs\/znae042"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00423\u2010023\u201003069\u2010y"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.15956"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjs\/znad301"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.4832"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.12944"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/dcr.0b013e31827a267c"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.21517"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.20382"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.766"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471\u20100528.1993.tb12955.x"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/0090\u20108258(81)90136\u20100"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/0090\u20108258(75)90040\u20102"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102023\u2010076538"},{"key":"e_1_2_9_19_1","volume-title":"Interpretative Phenomenological Analysis. 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