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Surgical treatment of endometrial cancer in developing countries: reasons to consider systematic two-step surgical treatment
Anton, Cristina; Fávero, Giovanni Mastrantonio di; Köhler, Christhardt; Carvalho, Filomena Marino; Baracat, Edmund Chada; Carvalho, Jesus Paula.
  • Anton, Cristina; Faculdade de Medicina da Universidade de São Paulo. Department of Obstetrics and Gynecology. São Paulo. BR
  • Fávero, Giovanni Mastrantonio di; Faculdade de Medicina da Universidade de São Paulo. Department of Obstetrics and Gynecology. São Paulo. BR
  • Köhler, Christhardt; Faculdade de Medicina da Universidade de São Paulo. Department of Obstetrics and Gynecology. São Paulo. BR
  • Carvalho, Filomena Marino; Faculdade de Medicina da Universidade de São Paulo. Department of Obstetrics and Gynecology. São Paulo. BR
  • Baracat, Edmund Chada; Faculdade de Medicina da Universidade de São Paulo. Department of Obstetrics and Gynecology. São Paulo. BR
  • Carvalho, Jesus Paula; Faculdade de Medicina da Universidade de São Paulo. Department of Obstetrics and Gynecology. São Paulo. BR
Clinics ; 70(7): 470-474, 2015. tab
Artículo en Inglés | LILACS | ID: lil-752400
ABSTRACT

OBJECTIVE:

The aim of this study was to determine the lymph node status in a large cohort of women with endometrial cancer from the public health system who were referred to an oncology reference center in Brazil to identify candidates for the omission of lymphadenectomy based on clinicopathological parameters.

METHODS:

We retrospectively analyzed a cohort of 310 women with endometrial cancer (255 endometrioid, 40 serous, and 15 clear cell tumors) treated between 2009 and 2014. We evaluated the histological type, grade (low vs. high), tumor size (cm), depth of myometrial invasion (≤50%, >50%) and lymphovascular space invasion to determine which factors were correlated with the presence of lymph node metastasis.

RESULTS:

The factors related to lymph node involvement were tumor size (p=0.03), myometrial invasion (p<0.01), tumor grade (p<0.01), and lymphovascular space invasion (p<0.01). The histological type was not associated with the nodal status (p=0.52). Only twelve of 176 patients (6.8%) had low-grade endometrioid carcinoma, tumor size ≤2 cm and <50% myometrial infiltration.

CONCLUSIONS:

The omission of lymphadenectomy based on the histological type, grade, tumor size and depth of myometrial invasion is not likely to have a large impact on the surgical treatment of endometrial cancer in our population because most patients present with large and advanced tumors. New strategies are proposed that prioritize hysterectomy performed in a general hospital as soon as possible after diagnosis, followed by an evaluation of the need for lymph node dissection at a reference center. .
Asunto(s)


Texto completo: Disponible Índice: LILACS (Américas) Asunto principal: Neoplasias Endometriales / Escisión del Ganglio Linfático Tipo de estudio: Estudio observacional / Estudio pronóstico / Factores de riesgo Límite: Adulto / Anciano / Aged80 / Femenino / Humanos País/Región como asunto: America del Sur / Brasil Idioma: Inglés Revista: Clinics Asunto de la revista: Medicina Año: 2015 Tipo del documento: Artículo País de afiliación: Brasil Institución/País de afiliación: Faculdade de Medicina da Universidade de São Paulo/BR

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Texto completo: Disponible Índice: LILACS (Américas) Asunto principal: Neoplasias Endometriales / Escisión del Ganglio Linfático Tipo de estudio: Estudio observacional / Estudio pronóstico / Factores de riesgo Límite: Adulto / Anciano / Aged80 / Femenino / Humanos País/Región como asunto: America del Sur / Brasil Idioma: Inglés Revista: Clinics Asunto de la revista: Medicina Año: 2015 Tipo del documento: Artículo País de afiliación: Brasil Institución/País de afiliación: Faculdade de Medicina da Universidade de São Paulo/BR