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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
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. .
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Texte intégral: Disponible Indice: LILAS (Amériques) Sujet Principal: Tumeurs de l&apos;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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Texte intégral: Disponible Indice: LILAS (Amériques) Sujet Principal: Tumeurs de l&apos;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