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2015 | 13 | 2 | 99-105
Article title

Rozległość limfadenektomii w raku endometrium oraz jej wpływ na utratę krwi i czas trwania zabiegu

Content
Title variants
EN
The extent of lymphadenectomy in endometrial cancer and its effect on blood loss and procedure duration
Languages of publication
EN PL
Abstracts
EN
The clinical staging of endometrial cancer is performed based on surgical-pathological criteria. The extent of lymph node dissection represents a clinical problem. The study was performed in order to assess the occurrence of metastases in iliac and para-aortic lymph nodes as well as to compare selected surgical risk factors in the case of extending the surgery with the dissection of these lymph nodes. The control group included 27 patients undergoing hysterectomy with iliac lymph node dissection; the study group included 30 patients after iliac and para-aortic lymph node removal. The incidence of metastases was assessed as well as the duration of procedure and intraoperative blood loss were compared. Metastases to lymph nodes were found in 10 (17.5%) females. Iliac lymph node metastases were detected in four patients (14.8%) in group I. In group II, metastases were detected in six (20%) patients: isolated para-aortic metastases in two patients (6.67%), para-aortic and iliac metastases in four (13.33%) patients. Statistically significant difference (p = 0.0035) was found in the duration of procedures: the median was 102.5 minutes for iliac lymphadenectomy, and 132.5 minutes for iliac/para-aortic lymphadenectomy; the maximum duration of iliac/para-aortic lymphadenectomy was 20 minutes longer. There was no statistically significant difference in blood loss (p = 0.4980). However, significantly higher maximum blood loss volume was noticeable in the study group. It is necessary to adjust the para-aortic lymphadenectomy in endometrial cancer to patient’s health status as well as to make maximum use of preoperative diagnostics. The procedure should be performed by a specialist experienced in gynecologic oncology to minimize the surgical risk. Information on lymph node status is the most important prognostic factor in endometrial cancer, which allows for a proper qualification for adjuvant therapy.
Discipline
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Year
Volume
13
Issue
2
Pages
99-105
Physical description
Contributors
  • Oddział Ginekologii i Położnictwa z Ginekologią Onkologiczną, Szpital Specjalistyczny im. Ludwika Rydygiera w Krakowie, Polska. Ordynator Oddziału: dr n. med. Marcin Opławski, oplawski.m@gmail.com
author
  • Klinika Ginekologii Onkologicznej, Centrum Onkologii – Instytut im. Marii Skłodowskiej-Curie, Oddział w Krakowie, Polska. Kierownik Kliniki: dr hab. n. med. Paweł Blecharz
  • Oddział Ginekologii i Położnictwa z Ginekologią Onkologiczną, Szpital Specjalistyczny im. Ludwika Rydygiera w Krakowie, Polska. Ordynator Oddziału: dr n. med. Marcin Opławski
author
  • Klinika Ginekologii Onkologicznej, Centrum Onkologii – Instytut im. Marii Skłodowskiej-Curie, Oddział w Krakowie, Polska. Kierownik Kliniki: dr hab. n. med. Paweł Blecharz
References
  • Lewin SN, Herzog TJ, Barrena Medel NI et al.: Comparative performance of the 2009 International Federation of Gynecology and Obstetrics’ staging system for uterine corpus cancer. Obstet Gynecol 2010; 116: 1141–1149.
  • Benedetti Panici P, di Donato V, Plotti F et al.: Role of lymphadenectomy in gynaecologic cancers. In: Ayhan A, Gultekin M, Dursun P (eds.): Textbook of Gynaecological Oncology. Güneş Publishing, Ankara 2010: 252–256.
  • Pomel C, Naik R, Martinez A et al.: Systematic (complete) para-aortic lymphadenectomy: description of a novel classification with technical and anatomical considerations. BJOG 2012; 119: 249–253.
  • ASTEC study group; Kitchener H, Sward AM, Qian Q et al.: Efficacy of systematic pelvic lymphadenectomy in endometrial cancer (MRC ASTEC trial): a randomised study. Lancet 2009; 373: 125–136.
  • Forde GK, Carlson JW, Downey GO et al.: A quality process study of lymph node evaluation in endometrial cancer. Int J Gynecol Pathol 2011; 30: 335–339.
  • Ueda Y, Okazawa M, Enomoto T et al.: Dissection of unsuspicious para-aortic lymph nodes does not improve prognosis of advanced endometrial carcinoma with intra- or extra-abdominal metastasis. Anticancer Res 2011; 31: 4513–4517.
  • Todo Y, Kato H, Kaneuchi M et al.: Survival effect of para-aortic lymphadenectomy in endometrial cancer (SEPAL study): a retrospective cohort analysis. Lancet 2010; 375: 1165–1172.
  • Turan T, Hizli D, Sarici S et al.: Is it possible to predict para-aortic lymph node metastasis in endometrial cancer? Eur J Obstet Gynecol Reprod Biol 2011; 158: 274–279.
  • Smith DC, Macdonald OK, Lee CM et al.: Survival impact of lymph node dissection in endometrial adenocarcinoma: a surveillance, epidemiology, and end results analysis. Int J Gynecol Cancer 2008; 18: 255–261.
  • Furberg AS, Thune I: Metabolic abnormalities (hypertension, hyperglycemia and overweight), lifestyle (high energy intake and physical inactivity) and endometrial cancer risk in a Norwegian cohort. Int J Cancer 2003; 104: 669–676.
  • Frumovitz M, Bodurka DC, Broaddus RR et al.: Lymphatic mapping and sentinel node biopsy in women with high-risk endometrial cancer. Gynecol Oncol 2007; 104: 100–103.
  • Pityński K, Basta A, Opławski M et al.: Znakowanie węzłów limfatycznych i poszukiwanie węzła wartowniczego w raku szyjki macicy, raku endometrium i raku sromu. Ginekol Pol 2003; 74: 830–835.
  • Petersen RW, Quinlivan JA, Casper GR et al.: Endometrial adenocarcinoma – presenting pathology is a poor guide to surgical management. Aust N Z J Obstet Gynaecol 2000; 40: 191–194.
  • Eltabbakh GH, Shamonki MI, Moody JM et al.: Laparoscopy as the primary modality for the treatment of woman with endometrial carcinoma. Cancer 2001; 91: 378–387.
  • Kang S, Todo T, Odagiri T et al.: A low-risk group of lymph node metastasis is accurately identified by Korean gynecologic oncology group criteria in two Japanese cohorts with endometrial cancer. Gynecol Oncol 2013; 129: 33–37.
Document Type
article
Publication order reference
Identifiers
YADDA identifier
bwmeta1.element.psjd-44de12ad-5a17-4a1f-bdbd-cf3c7b10af93
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