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Controversies in Surgical Staging of Endometrial Cancer

Endometrial cancer is the most common gynaecological malignancy and its incidence is increasing. In 1998, international federation of gynaecologists and obstetricians (FIGO) required a change from clinical to surgical staging in endometrial cancer, introducing pelvic and paraaortic lymphadenectomy....

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Autores principales: Seracchioli, R., Solfrini, S., Mabrouk, M., Facchini, C., Di Donato, N., Manuzzi, L., Savelli, L., Venturoli, S.
Formato: Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2896614/
https://www.ncbi.nlm.nih.gov/pubmed/20613992
http://dx.doi.org/10.1155/2010/181963
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author Seracchioli, R.
Solfrini, S.
Mabrouk, M.
Facchini, C.
Di Donato, N.
Manuzzi, L.
Savelli, L.
Venturoli, S.
author_facet Seracchioli, R.
Solfrini, S.
Mabrouk, M.
Facchini, C.
Di Donato, N.
Manuzzi, L.
Savelli, L.
Venturoli, S.
author_sort Seracchioli, R.
collection PubMed
description Endometrial cancer is the most common gynaecological malignancy and its incidence is increasing. In 1998, international federation of gynaecologists and obstetricians (FIGO) required a change from clinical to surgical staging in endometrial cancer, introducing pelvic and paraaortic lymphadenectomy. This staging requirement raised controversies around the importance of determining nodal status and impact of lymphadenectomy on outcomes. There is agreement about the prognostic value of lymphadenectomy, but its extent, therapeutic value, and benefits in terms of survival are still matter of debate, especially in early stages. Accurate preoperative risk stratification can guide to the appropriate type of surgery by selecting patients who benefit of lymphadenectomy. However, available preoperative and intraoperative investigations are not highly accurate methods to detect lymph nodes and a complete surgical staging remains the most precise method to evaluate extrauterine spread of the disease. Laparotomy has always been considered the standard approach for endometrial cancer surgical staging. Traditional and robotic-assisted laparoscopic techniques seem to provide equivalent results in terms of disease-free survival and overall survival compared to laparotomy. These minimally invasive approaches demonstrated additional benefits as shorter hospital stay, less use of pain killers, lower rate of complications and improved quality of life.
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spelling pubmed-28966142010-07-07 Controversies in Surgical Staging of Endometrial Cancer Seracchioli, R. Solfrini, S. Mabrouk, M. Facchini, C. Di Donato, N. Manuzzi, L. Savelli, L. Venturoli, S. Obstet Gynecol Int Review Article Endometrial cancer is the most common gynaecological malignancy and its incidence is increasing. In 1998, international federation of gynaecologists and obstetricians (FIGO) required a change from clinical to surgical staging in endometrial cancer, introducing pelvic and paraaortic lymphadenectomy. This staging requirement raised controversies around the importance of determining nodal status and impact of lymphadenectomy on outcomes. There is agreement about the prognostic value of lymphadenectomy, but its extent, therapeutic value, and benefits in terms of survival are still matter of debate, especially in early stages. Accurate preoperative risk stratification can guide to the appropriate type of surgery by selecting patients who benefit of lymphadenectomy. However, available preoperative and intraoperative investigations are not highly accurate methods to detect lymph nodes and a complete surgical staging remains the most precise method to evaluate extrauterine spread of the disease. Laparotomy has always been considered the standard approach for endometrial cancer surgical staging. Traditional and robotic-assisted laparoscopic techniques seem to provide equivalent results in terms of disease-free survival and overall survival compared to laparotomy. These minimally invasive approaches demonstrated additional benefits as shorter hospital stay, less use of pain killers, lower rate of complications and improved quality of life. Hindawi Publishing Corporation 2010 2010-06-23 /pmc/articles/PMC2896614/ /pubmed/20613992 http://dx.doi.org/10.1155/2010/181963 Text en Copyright © 2010 R. Seracchioli et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Seracchioli, R.
Solfrini, S.
Mabrouk, M.
Facchini, C.
Di Donato, N.
Manuzzi, L.
Savelli, L.
Venturoli, S.
Controversies in Surgical Staging of Endometrial Cancer
title Controversies in Surgical Staging of Endometrial Cancer
title_full Controversies in Surgical Staging of Endometrial Cancer
title_fullStr Controversies in Surgical Staging of Endometrial Cancer
title_full_unstemmed Controversies in Surgical Staging of Endometrial Cancer
title_short Controversies in Surgical Staging of Endometrial Cancer
title_sort controversies in surgical staging of endometrial cancer
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2896614/
https://www.ncbi.nlm.nih.gov/pubmed/20613992
http://dx.doi.org/10.1155/2010/181963
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