کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
6184402 | 1254209 | 2014 | 5 صفحه PDF | دانلود رایگان |
- We report clinical outcomes of endometrial cancer surgically staged without lymphadenectomy.
- Intra-operative evaluation is accurate in identifying low risk endometrial cancer.
- Cancer recurrence rates for low risk disease are acceptable using this methodology.
ObjectiveThe objective of the study was to evaluate clinical outcomes in patients with stage I endometrial cancer undergoing surgical management without lymphadenectomy based on intra-operative assessment for low-risk disease.MethodsBetween 2000 and 2009, a total of 179 patients were surgically staged without lymphadenectomy for low-risk stage I endometrial cancer. Low-risk cancer was defined by intra-operative criteria based on both gross and frozen tissue microscopic evaluation: 1) G1 or G2 endometrioid histology; 2) myoinvasion <Â 50%; 3) no cervical disease, and 4) no intra-abdominal metastasis. Records were reviewed for postoperative complications, pathological diagnoses, adjuvant radiation treatment, cancer recurrence, and mortality.ResultsMorbidity, cancer recurrence, and disease-specific mortality were low. Postoperative complications occurred in 5 patients (2.8%). Nine patients (5.0%) were offered adjuvant radiation for higher risk disease diagnosed on final pathology. Radiation morbidity was minimal: grade 1 vaginal toxicity in 2 patients. Three patients (1.7%) experienced recurrent cancer with mean time to recurrence of 43.7Â months. Five year overall survival was 95.8%. The five year probability of disease-specific death was 1.1%.ConclusionIn an institution with reliable capability of pathological frozen tissue diagnosis, omission of lymph node dissection is a reasonable option in the surgical management of those patients with low-risk disease diagnosed by intra-operative factors.
Journal: Gynecologic Oncology - Volume 134, Issue 3, September 2014, Pages 505-509