Surgical treatment of endometrial cancer in developing countries: reasons to consider systematic two-step surgical treatment
Clinics
;
70(7): 470-474, 2015. tab
Article
Dans Anglais
| 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. .
Texte intégral:
Disponible
Indice:
LILAS (Amériques)
Sujet Principal:
Tumeurs de l'endomètre
/
Lymphadénectomie
Type d'étude:
Étude observationnelle
/
Étude pronostique
/
Facteurs de risque
Limites du sujet:
Adulte
/
Adulte très âgé
/
Aged80
/
Femelle
/
Humains
Pays comme sujet:
Amérique du Sud
/
Brésil
langue:
Anglais
Texte intégral:
Clinics
Thème du journal:
Médicament
Année:
2015
Type:
Article
Pays d'affiliation:
Brésil
Institution/Pays d'affiliation:
Faculdade de Medicina da Universidade de São Paulo/BR
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