Surgical treatment of endometrial cancer in developing countries: reasons to consider systematic two-step surgical treatment

Imagem de Miniatura
Arquivos
art_ANTON_Surgical_treatment_of_endometrial_cancer_in_developing_countries_2015.PDF (169.6 KB)
Citações na Scopus
9
Tipo de produção
article
Data de publicação
2015
DOI
SciELO
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
HOSPITAL CLINICAS, UNIV SAO PAULO
Autores
KOEHLER, Christhardt
Citação
CLINICS, v.70, n.7, p.470-474, 2015
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
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.
Palavras-chave
Endometrial cancer, Lymph node dissection, Myometrial invasion, Lymphovascular space invasion, Surgery
URI
https://observatorio.fm.usp.br/handle/OPI/11828
Referências
  1. Coronado PJ, 2014, INT J GYNECOL CANCER, V24, P703, DOI 10.1097/IGC.0000000000000120
  2. Courtney-Brooks M, 2014, INT J GYNECOL CANCER, V24, P91, DOI 10.1097/IGC.0000000000000008
  3. Dogan NU, 2012, INT J GYNECOL CANCER, V22, P607, DOI 10.1097/IGC.0b013e3182434adb
  4. Dowdy SC, 2012, GYNECOL ONCOL, V127, P5, DOI 10.1016/j.ygyno.2012.06.035
  5. Falcone F, 2014, MED SCI MONITOR, V20, P1298, DOI 10.12659/MSM.890478
  6. Favero G, 2014, INT J GYNECOL CANCER, V24, P822, DOI 10.1097/IGC.0000000000000132
  7. Franchi M, 2001, J SURG ONCOL, V78, P232, DOI 10.1002/jso.1158
  8. Gerber B, 2001, EUR J CANCER, V37, P64, DOI 10.1016/S0959-8049(00)00356-7
  9. Goss PE, 2013, LANCET ONCOL, V14, P391, DOI 10.1016/S1470-2045(13)70048-2
  10. Han SS, 2010, ACTA OBSTET GYN SCAN, V89, P168, DOI 10.3109/00016340903370114
  11. Kim HS, 2012, JPN J CLIN ONCOL, V42, P405, DOI 10.1093/jjco/hys019
  12. Kitchener H, 2009, LANCET, V373, P125, DOI 10.1016/S0140-6736(08)61766-3
  13. Kodama J, 2006, EUR J OBSTET GYN R B, V124, P222, DOI 10.1016/j.ejogrb.2005.06.027
  14. Koskas M, 2014, EUR J OBSTET GYN R B, V172, P115, DOI 10.1016/j.ejogrb.2013.10.028
  15. Kumar S, 2013, GYNECOL ONCOL, V130, P441, DOI 10.1016/j.ygyno.2013.05.035
  16. Loizzi V, 2014, EUR J CANCER CARE, V23, P380, DOI 10.1111/ecc.12115
  17. Luomaranta A, 2014, INT J GYNECOL CANCER, V24, P697, DOI 10.1097/IGC.0000000000000113
  18. Maggino T, 1998, GYNECOL ONCOL, V68, P274, DOI 10.1006/gyno.1998.4951
  19. Maggino T, 1995, EUR J CANCER, V31A, P1993, DOI 10.1016/0959-8049(95)00316-9
  20. Mariani A, 2009, INT J GYNECOL OBSTET, V105, P110, DOI 10.1016/j.ijgo.2009.02.008
  21. Mariani A, 2008, GYNECOL ONCOL, V109, P11, DOI 10.1016/j.ygyno.2008.01.023
  22. Mariani A, 2000, AM J OBSTET GYNECOL, V182, P1506, DOI 10.1067/mob.2000.107335
  23. May K, 2010, COCHRANE DB SYST REV, DOI 10.1002/14651858.CD007585.pub2
  24. McMeekin DS, 2011, AM J OBSTET GYNECOL, V205, P509, DOI 10.1016/j.ajog.2011.09.003
  25. Narayan K, 2012, INT J GYNECOL CANCER, V22, P260, DOI 10.1097/IGC.0b013e318230c264
  26. Pecorelli S, 2009, INT J GYNECOL OBSTET, V105, P103, DOI 10.1016/j.ijgo.2009.02.012
  27. Saarelainen SK, 2013, AM J OBSTET GYNECOL, V209, p142e1
  28. Siegel R, 2013, CA-CANCER J CLIN, V63, P11, DOI 10.3322/caac.21166
  29. Todo Y, 2014, J OBSTET GYNAECOL RE, V40, P317, DOI 10.1111/jog.12309
  30. Todo Y, 2010, LANCET, V375, P1165, DOI 10.1016/S0140-6736(09)62002-X
  31. Vidal F, 2013, OBSTET GYNECOL INT, V2013
  32. Watari H, 2005, GYNECOL ONCOL, V96, P651, DOI 10.1016/j.ygyno.2004.11.026
  33. Weinberg LE, 2013, INT J GYNECOL CANCER, V23, P1438, DOI 10.1097/IGC.0b013e3182a16c93

Coleções
Artigos e Materiais de Revistas Científicas - FM/MPT
Artigos e Materiais de Revistas Científicas - FM/MOG
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/14
Artigos e Materiais de Revistas Científicas - LIM/58
Carregar mais