scholarly journals Controversies in the Treatment of Early Stage Endometrial Carcinoma

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Joshua Z. Press ◽  
Walter H. Gotlieb
Keyword(s):  
Endometrial Cancer ◽  
Adjuvant Chemotherapy ◽  
Early Stage ◽  
Sentinel Lymph Node Mapping ◽  
Optimal Management ◽  
Lymph Node Mapping ◽  
Randomized Controlled ◽  
Extent Of Surgery ◽  
Early Stage Endometrial Cancer

Despite the publication of numerous studies, including some multicentered randomized controlled trials, there continues to be vigorous debate regarding the optimal management of early stage endometrial cancer, including the extent of surgery and the role of adjuvant chemotherapy and radiation. Resolving these questions has become increasingly important in view of the increase of endometrial cancer, related to the aging population and the alarming incidence of obesity. Furthermore, there are more surgical challenges encountered when operating on elderly patients or on patients with increased BMI and the associated comorbidities, such as diabetes, hypertension, heart disease, and pulmonary dysfunction. This paper will focus on the advantages of minimally invasive surgery, the value of lymphadenectomy including sentinel lymph node mapping, and some of the current controversies surrounding adjuvant chemotherapy and radiation.

Sentinel Lymph Node Mapping in Early Stage Endometrial Cancer Patients in Low-Resource Settings

2020 ◽  
Vol 17 ◽  
Author(s):  
Mahmoud Abubakr Negm ◽  
Ashraf Nasr Refaie ◽  
Magdi Ragab El-Sayed ◽  
Hesham R. Abdel Azeez ◽  
Abdalla Hassan Gad ◽  
...  
Keyword(s):  
Methylene Blue ◽  
Endometrial Cancer ◽  
Lymph Node ◽  
Detection Rate ◽  
Early Stage ◽  
False Negative ◽  
False Negative Rate ◽  
Sentinel Lymph Node Mapping ◽  
Lymph Node Mapping ◽  
Early Stage Endometrial Cancer

Background:: Lymph node status has a prognostic role in endometrial cancer patients and it determines the adjuvant therapy to be administered postoperatively. Complete lymphadenectomy carries the risk of serious complications. Sentinel lymph node mapping (SLN) may be a good option to reduce these complications. Cervical injection of methylene blue may be a suitable technique for SLN mapping, which can be applied in low-resource institutes. Objective:: Assessment of the detection rate, sensitivity and false negative rate of SLN mapping using cervical injection of methylene blue. Methods:: A total of 76 patients with early stage endometrial cancer were included. Methylene blue was injected into the cervix prior to surgery and open surgical approach was used. SLNs were detected by direct visualization of stained lymph nodes after opening of pelvic spaces. SLNs were excised and pelvic lymphadenectomy was performed. Para-aortic lymphadenectomy was performed when indicated and surgically feasible. Specimens were examined by H&E staining. Results:: The SLN detection rate was 47.4% and all detected SLNs were pelvic nodes. All patients with lymph node metastasis had metastatic disease in their SLNs. The technique had 100% sensitivity, 100% negative predictive value and a 0% false negative rate. An inverse relationship between SLN detection and BMI was detected. Conclusion:: Cervical injection of methylene blue dye with an open approach to detect SLNs in patients with early stage endometrial cancer has a low detection rate. The most important factor associated with failed mapping is increased BMI. Further trials are needed to investigate the usefulness of this technique.

scholarly journals The Survival Effect of Ovary Preservation in Early Stage Endometrial Cancer: A Single Institution Retrospective Analysis

2020 ◽  
Author(s):  
Wonkyo Shin ◽  
Sang-Yoon Park ◽  
Sokbom Kang ◽  
Myong Cheol Lim ◽  
Sang-Soo Seo
Keyword(s):  
Endometrial Cancer ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Early Stage ◽  
Figo Stage ◽  
Factors Affecting ◽  
Chemotherapy Administration ◽  
Survival Effect ◽  
Removal Group ◽  
Early Stage Endometrial Cancer

Abstract Purpose: We investigated the effect of ovary preserving surgery in early International Federation of Obstetrics and Gynecology (FIGO) stage endometrial cancer patients.Methods: Medical records were retrospectively reviewed for 539 patients who were diagnosed with early stage endometrial cancer between Jan 2006 and Dec 2017. Patients were categorized into ovary preservation and ovary removal groups. Demographics, recurrence free survival (RFS), and five-year overall survival (OS) rate were compared, and the clinical factors affecting survival were evaluated by univariate and multivariate analysis.Results: The median follow-up period was 85 months (range, 6-142 months), and the median age was 52.7 years. The mean age was higher in the ovary removal group than in the ovary preservation group (54.4 vs 40.94 years; P < 0.001). The ovary preservation group showed an earlier FIGO stage than the ovary removal group. (P = 0.0264). There was a greater incidence of adjuvant chemotherapy administration in the removal group. There were no statistical differences in other baseline characteristics.When comparing the RFS and OS rates, there were no statistical differences between the preservation and removal groups. (recurrence free rate 98.5% vs 92.7%, p = 0.4360, and 5-year survival rate 98.6% vs 93.0%, p = 0.0892, respectively). Endometrioid histology (p=0.006) and post-operative adjuvant chemotherapy (p=0.0062) were related to OS, and adjuvant chemotherapy (p<0.001) and radiotherapy (p=0.005) were related to RFSConclusions: Ovary preservation in early stage endometrial cancer is worth considering, as it does not affect survival in early stage endometrial cancer patients

The role of L1CAM in early-stage endometrial cancer recurrence

2018 ◽  
Vol 149 ◽  
pp. 61
Author(s):  
C.M. Dahl ◽  
S. Bedell ◽  
L. Uppendahl ◽  
T. Pulver ◽  
R. Hellweg ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Early Stage ◽  
Cancer Recurrence ◽  
Early Stage Endometrial Cancer

scholarly journals Therapeutic role of systematic lymphadenectomy in early-stage endometrial cancer: A systematic review

2016 ◽  
Vol 11 (6) ◽  
pp. 3849-3857 ◽  
Author(s):  
MEI-YI LI ◽  
XIAO-XIA HU ◽  
JIAN-HONG ZHONG ◽  
LU-LU CHEN ◽  
YONG-XIU LIN
Keyword(s):  
Systematic Review ◽  
Endometrial Cancer ◽  
Early Stage ◽  
Therapeutic Role ◽  
Systematic Lymphadenectomy ◽  
Early Stage Endometrial Cancer
Sign in / Sign up

Export Citation Format

Share Document