Lymphovascular Space Invasion for Endometrial Cancer: Undertreatment and Overtreatment Risks
| Autor: | Blanca Gil-Ibáñez, Begoña Díaz de la Noval, Mikel Gorostidi Pulgar, Pablo Padilla Iserte, Ibon Jaunarena Marin, Victor Lago Leal |
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| Rok vydání: | 2017 |
| Předmět: |
Gynecology
Response rate (survey) medicine.medical_specialty Lymphatic metastasis 030219 obstetrics & reproductive medicine Cross-sectional study business.industry Obstetrics Endometrial cancer Obstetrics and Gynecology medicine.disease Lymphovascular 03 medical and health sciences 0302 clinical medicine Oncology Neoplasm Invasiveness 030220 oncology & carcinogenesis medicine business Surgical treatment Oncology field |
| Zdroj: | International Journal of Gynecologic Cancer. 27:1191-1199 |
| ISSN: | 1525-1438 1048-891X |
| Popis: | ObjectiveThe purpose of this study is to asses the impact of lymphovascular space invasion (LVSI) present in early-stage endometrial cancer, regarding its therapeutic management and prognosis knowledge, based on a survey among Spanish oncologic gynecologist.Methods/MaterialsBetween October and November 2014, the Young Spanish Onco-gynecologist Group carried out a survey to perform a cross-sectional study about the management of LVSI. All active members in the oncology field of the Spanish Society of Gynecology and Obstetrics were invited to participate in the survey.ResultsMost respondents consider LVSI a bad prognosis factor for endometrial cancer (66%) and also consider that it should be included in the International Federation of Gynecology and Obstetrics classification (56%). Seventy-five percent of all gynecologists did not modify their surgical treatment. Regarding follow-up, 38% of the respondents do not change their surveillance, 28% modify it, and 31% reported any change only with additional factors. Forty-seven percent of respondents advise systemic treatment with chemotherapy.Data were dichotomized between less than or equal to 20 versus greater than 20 years of OB-GYN specialist and less than or equal to 5 versus greater than 5 years of main dedication to gynecology oncology, but it was not possible to show any significant differences among the groups. The response rate (34 individuals) was too low to expect any significant differences.ConclusionsResults suggest that LVSI remains a controversial issue in the management of patients with endometrial cancer. Acquiring a deeper knowledge and uniform criteria could avoid the risk of undertreatment and overtreatment in this group of patients with early-stage endometrial cancer. The identification of vascular pseudoinvasion is recommended, although the clinical and prognostic implications still need to be determined. |
| Databáze: | OpenAIRE |
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