Efficacy of Para-Aortic Lymphadenectomy in Early-Stage Endometrioid Uterine Corpus Cancer
| Autor: | Seok Mo Kim, Chi Heum Cho, Jae Weon Kim, Chan Yong Park, Jae Kwan Lee, Jong Min Lee, Ki Tae Kim, Seo Yun Tong, Sang Yoon Park |
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| Rok vydání: | 2010 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Hysterectomy Pelvis Surgical oncology Uterine cancer Humans Medicine Para aortic lymphadenectomy Stage (cooking) Pelvic lymphadenectomy Aorta Neoplasm Staging Retrospective Studies business.industry Middle Aged medicine.disease Endometrial Neoplasms Surgery Uterine Corpus Cancer Survival Rate Treatment Outcome Oncology Lymphatic Metastasis Uterine Neoplasms Myometrium Lymph Node Excision Female Lymphadenectomy Neoplasm Recurrence Local business Follow-Up Studies |
| Zdroj: | Annals of Surgical Oncology. 18:1425-1430 |
| ISSN: | 1534-4681 1068-9265 |
| DOI: | 10.1245/s10434-010-1472-7 |
| Popis: | The objective of this study was to assess whether para-aortic lymphadenectomy has therapeutic efficacy for patients with early-stage endometrioid uterine cancer who underwent systematic pelvic lymphadenectomy.The authors retrospectively reviewed the medical records and pathological findings of 547 patients with histologically proven FIGO stage I-II endometrioid uterine cancer, based on comprehensive surgical staging, including pelvic with or without para-aortic lymphadenectomy.Among 547 patients, 330 patients had systematic pelvic lymphadenectomy only, and 217 had systematic pelvic with para-aortic lymphadenectomy. There were no significant differences in histopathological factors in the high-risk group, even though deep myometrial invasion (p = 0.02) and lymphvascular space invasion (p = 0.01) were more common in patients who underwent systematic pelvic with para-aortic lymphadenectomy in all study populations. Within a median follow-up of 31 (range, 5-120) months, there was no significant difference in overall survival between the pelvic lymphadenectomy only and pelvic with para-aortic lymphadenectomy groups in all populations (p = 0.77), even in high-risk patients (p = 0.82). Upon multivariate analysis, patients with lymphvascular space invasion had significantly worse overall survival (odds ratio (OR) = 7.38; 95% confidence interval (CI) = 1.86-29.23; p = 0.004).Although a prospective, randomized study needs to be performed for confirmation, our data suggest that the therapeutic benefit of para-aortic lymphadenectomy is uncertain in stage I and II endometrioid uterine corpus cancer, even in patients at high-risk for recurrence. |
| Databáze: | OpenAIRE |
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