Abstract
Purpose
Determination of early disease recurrence in patients with early-stage endometrial cancer operated laparoscopically without pelvic or paraaortic lymphadenectomy.
Methods
Retrospective chart review of all patients with endometrial carcinoma operated with laparoscopic-assisted vaginal hysterectomy with bilateral salpingo-oophorectomy between 2004 and 2008.
Results
81 patients were eligible for data analysis. The operation time varied between 32 and 284 min. None of the patients suffered serious intraoperative complications. All patients had endometrial carcinoma of endometrioid type. As adjuvant therapy, patients received no further therapy (n = 30), radiation with brachytherapy with an afterloading technique alone (n = 36) or brachytherapy in combination with percutaneous radiation (n = 15). The observation period varied between 19 and 28 months (median 26 months). No patients were lost to follow-up. During the observation period, none of the patients had recurrence of disease or died.
Conclusions
Laparoscopic-assisted vaginal hysterectomy with bilateral salpingo-oophorectomy without pelvic or paraaortic lymphadenectomy combined with stage-adapted postoperative irradiation is a safe and efficient treatment option for patients with early-stage endometrial cancer of the endometriod type regarding early disease recurrence.
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References
Jemal A, Bray F, Center MM et al (2011) Global cancer statistics. CA Cancer J Clin 61:69–90
Waldmann A, Eisemann N, Katalinic A (2013) Epidemiology of malignant cervical, corpus uteri and ovarian tumours-current data and epidemiological trends. Geburtsh Frauenheilk 73:123–129
Siegel R, Naishadham D, Jemal A (2013) Cancer statistics. CA Cancer J Clin 63:11–30
DKG, DGGG, AGO (2013) Diagnostik und Therapie des Endometriumkarzinoms. http://www.dggg.de/fileadmin/public_docs/Leitlinien/g_01_02_07_diagnostik_therapie_endometriumkarzinoms.pdf. Accessed 31 Jan 2013
Sorosky JI (2012) Endometrial Cancer. Obstet Gynecol 120(2, Part 1):383–397
Kim HS, Kim HY, Park CY et al (2012) Lymphadenectomy increases the prognostic value of the revised 2009 FIGO staging system for endometrial cancer: a multi-center study. Eur J Surg Oncol 38:230–237
Querleu D, Leblanc E, Cartron G et al (2006) Audit of preoperative and early complications of laparoscopic lymph node dissection in 1000 gynecologic cancer patients. Am J Obstet Gynecol 195:1287–1292
Ghezzi F, Uccella S, Cromi A et al (2012) Lymphoceles, lymphorrhea, and lymphedema after laparoscopic and open endometrial cancer staging. Ann Surg Oncol 19:259–267
Achouri A, Huchon C, Bats AS et al (2013) Complications of lymphadenectomy for gynecologic cancer. Eur J Surg Oncol 39:81–86
May K, Bryant A, Dickinson HO et al (2010) Lymphadenectomy for the management of endometrial cancer. Cochrane Database Syst Rev (1):CD007585. doi:10.1002/14651858.CD007585.pub2
The writing committee on behalf of the ASTEC study group (2009) Efficacy of systematic pelvic lymphadenectomy in endometrial cancer (MRC ASTEC trial): a randomised study. Lancet 373:125–136
Denschlag D, Ulrich U, Emons G (2011) The diagnosis and treatment of endometrial cancer. Dtsch Arztebl Int 108:571–577
Panici PB, Basile S, Maneschi F et al (2008) Systematic pelvic lymphadenectomy vs no lymphadenectomy in early-stage endometrial carcinoma: randomized clinical trial. J Natl Cancer Inst 100:1707–1716
Wendel Naumann R (2012) The role of lymphadenectomy in endometrial cancer: was the ASTEC trial doomed by design and are we destined to repeat that mistake? Gynecol Oncol 126:5–11
Kim HS, Suh DH, Kim MK et al (2012) Systematic lymphadenectomy for survival in patients with endometrial cancer: a meta-analysis. Jpn J Clin Oncol 42:405–412
Bendifallah S, Koskas M, Ballester M et al (2012) The survival impact of systematic lymphadenectomy in endometrial cancer with the use of propensity score matching analysis. Am J Obstet Gynecol 206:500.e1–500.e11
Juhasz-Böss I, Haggag H, Baum S et al (2012) Laparoscopic and laparotomic approaches for endometrial cancer treatment: a comprehensive review. Arch Gynecol Obstet 286:167–172
Galaal K, Bryant A, Fisher AD et al (2012) Laparoscopy versus laparotomy for the management of early stage endometrial cancer. Cochrane Database Syst Rev (9):CD006655. doi:10.1002/14651858.CD006655.pub2
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De Wilde, R.L., Rafei, A. & Herrmann, A. Can a lymphadenectomy be avoided in early-stage endometrial adenocarcinoma?. Arch Gynecol Obstet 290, 973–978 (2014). https://doi.org/10.1007/s00404-014-3265-x
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DOI: https://doi.org/10.1007/s00404-014-3265-x