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Lymphadenectomy can be omitted for low-risk endometrial cancer based on preoperative assessments
OBJECTIVE: According to the International Federation of Gynecology and Obstetrics staging, some surgeons perform lymphadenectomy in all patients with early stage endometrial cancer to enable the accurate staging. However, there are some risks to lymphadenectomy such as lower limb lymphedema. The aim...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Asian Society of Gynecologic Oncology; Korean Society of Gynecologic Oncology
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195300/ https://www.ncbi.nlm.nih.gov/pubmed/25142623 http://dx.doi.org/10.3802/jgo.2014.25.4.301 |
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author | Mitamura, Takashi Watari, Hidemichi Todo, Yukiharu Kato, Tatsuya Konno, Yosuke Hosaka, Masayoshi Sakuragi, Noriaki |
author_facet | Mitamura, Takashi Watari, Hidemichi Todo, Yukiharu Kato, Tatsuya Konno, Yosuke Hosaka, Masayoshi Sakuragi, Noriaki |
author_sort | Mitamura, Takashi |
collection | PubMed |
description | OBJECTIVE: According to the International Federation of Gynecology and Obstetrics staging, some surgeons perform lymphadenectomy in all patients with early stage endometrial cancer to enable the accurate staging. However, there are some risks to lymphadenectomy such as lower limb lymphedema. The aim of this study was to investigate whether preoperative assessment is useful to select the patients in whom lymphadenectomy can be safely omitted. METHODS: We evaluated the risk of lymph node metastasis (LNM) using LNM score (histological grade, tumor volume measured in magnetic resonance imaging [MRI], and serum CA-125), myometrial invasion and extrautrerine spread assessed by MRI. Fifty-six patients of which LNM score was 0 and myometrial invasion was less than 50% were consecutively enrolled in the study in which a lymphadenectomy was initially intended not to perform. We analyzed several histological findings and investigated the recurrence rate and overall survival. RESULTS: Fifty-one patients underwent surgery without lymphadenectomy. Five (8.9%) who had obvious myometrial invasion intraoperatively underwent systematic lymphadenectomy. One (1.8%) with endometrial cancer which was considered to arise from adenomyosis had para-aortic LNM. Negative predictive value of deep myometrial invasion was 96.4% (54/56). During the mean follow-up period of 55 months, one patient with deep myometrial invasion who refused an adjuvant therapy had tumor recurrence. The overall survival rate was 100% during the study period. CONCLUSION: This preoperative assessment is useful to select the early stage endometrial cancer patients without risk of LNM and to safely omit lymphadenectomy. |
format | Online Article Text |
id | pubmed-4195300 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Asian Society of Gynecologic Oncology; Korean Society of Gynecologic Oncology |
record_format | MEDLINE/PubMed |
spelling | pubmed-41953002014-10-14 Lymphadenectomy can be omitted for low-risk endometrial cancer based on preoperative assessments Mitamura, Takashi Watari, Hidemichi Todo, Yukiharu Kato, Tatsuya Konno, Yosuke Hosaka, Masayoshi Sakuragi, Noriaki J Gynecol Oncol Original Article OBJECTIVE: According to the International Federation of Gynecology and Obstetrics staging, some surgeons perform lymphadenectomy in all patients with early stage endometrial cancer to enable the accurate staging. However, there are some risks to lymphadenectomy such as lower limb lymphedema. The aim of this study was to investigate whether preoperative assessment is useful to select the patients in whom lymphadenectomy can be safely omitted. METHODS: We evaluated the risk of lymph node metastasis (LNM) using LNM score (histological grade, tumor volume measured in magnetic resonance imaging [MRI], and serum CA-125), myometrial invasion and extrautrerine spread assessed by MRI. Fifty-six patients of which LNM score was 0 and myometrial invasion was less than 50% were consecutively enrolled in the study in which a lymphadenectomy was initially intended not to perform. We analyzed several histological findings and investigated the recurrence rate and overall survival. RESULTS: Fifty-one patients underwent surgery without lymphadenectomy. Five (8.9%) who had obvious myometrial invasion intraoperatively underwent systematic lymphadenectomy. One (1.8%) with endometrial cancer which was considered to arise from adenomyosis had para-aortic LNM. Negative predictive value of deep myometrial invasion was 96.4% (54/56). During the mean follow-up period of 55 months, one patient with deep myometrial invasion who refused an adjuvant therapy had tumor recurrence. The overall survival rate was 100% during the study period. CONCLUSION: This preoperative assessment is useful to select the early stage endometrial cancer patients without risk of LNM and to safely omit lymphadenectomy. Asian Society of Gynecologic Oncology; Korean Society of Gynecologic Oncology 2014-10 2014-10-07 /pmc/articles/PMC4195300/ /pubmed/25142623 http://dx.doi.org/10.3802/jgo.2014.25.4.301 Text en Copyright © 2014. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Mitamura, Takashi Watari, Hidemichi Todo, Yukiharu Kato, Tatsuya Konno, Yosuke Hosaka, Masayoshi Sakuragi, Noriaki Lymphadenectomy can be omitted for low-risk endometrial cancer based on preoperative assessments |
title | Lymphadenectomy can be omitted for low-risk endometrial cancer based on preoperative assessments |
title_full | Lymphadenectomy can be omitted for low-risk endometrial cancer based on preoperative assessments |
title_fullStr | Lymphadenectomy can be omitted for low-risk endometrial cancer based on preoperative assessments |
title_full_unstemmed | Lymphadenectomy can be omitted for low-risk endometrial cancer based on preoperative assessments |
title_short | Lymphadenectomy can be omitted for low-risk endometrial cancer based on preoperative assessments |
title_sort | lymphadenectomy can be omitted for low-risk endometrial cancer based on preoperative assessments |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195300/ https://www.ncbi.nlm.nih.gov/pubmed/25142623 http://dx.doi.org/10.3802/jgo.2014.25.4.301 |
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