Lymph node mapping and involvement in endometrial cancer
|
|
- Christina Craig
- 6 years ago
- Views:
Transcription
1 American Journal of Clinical Cancer Research Burcu Kasap et al. American Journal of Clinical Cancer Research 2013, 1:1-10 American Journals of Clinical Cancer Research Vol. 1, Article ID , Page 1 10 of 10 pages Research Article Lymph node mapping and involvement in endometrial cancer Burcu Kasap 1, Aykut Özcan 1, Hakan Yetimalar 1, Aşkın Yıldız 1*, İncim Bezircioğlu 1, Dilek Uysal 1, Derya Kılıç Sakarya 1 1 Department of Obstetrics and Gynecology Clinic, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Turkey Abstract Objectives: The aim of this study was to evaluate the outcome of pelvic and/or para-aortic lymph node dissection in patients with endometrial cancer with regard to lymph node positivity. Materials and Methods: Retrospective chart review of 125 women with pathologically proven endometrial carcinoma who underwent a systematic surgical staging including lymphadenectomy between January 2006 and January 2011 was performed. Patients characteristics, histological findings, lymph node localization and involvement were analyzed. Detailed description of the extirpated and affected lymph nodes divided by area in the 125 patients with endometrial cancer were done. Results: The medical records for 125 patients were eligible for analysis. The mean number of all lymph nodes removed in operation was 38.9± (range 9 to 81 nodes). The mean number of pelvic lymph nodes (PLN) removed was 32± (range 9 to 75 nodes) and the mean number of para-aortic lymph nodes (PALN) removed was 7±5.123 (range 0 to 20 nodes). In the 24 patients with nodal metastasis, the mean number of all lymph nodes removed was 37.88± (range 9 to 81 nodes). The mean number of PLNs removed was 30.71±14.79 (range 9 to 66 nodes) and the mean number of PALNs removed was 7.17±4.198 (range 0 to 16 nodes). Nodal metastasis was shown in 24 (19.2%) patients. Isolated pelvic lymph node metastasis was shown in nine (37%) patients; isolated para-aortic lymph node metastasis was shown in one (4%) patient; both pelvic and para-aortic lymph node metastasis was shown in 14 (59%) patients. The most affected lymph node area was left external iliac artery with a ratio of 14%. Conclusions: In the field of gynecologic cancer surgery, for the determination of adequate number of lymph nodes to be retrieved, lymph node mapping plays a crucial role, and this issue should be investigated in studies performed with larger number of cases in order to standardize procedure of lymphadenectomy. Keywords: endometrial carcinoma; lymph node metastasis; lymphadenectomy Peer Reviewers: Reuven Reich, PhD, Institute for Drug Research, Hebrew University of Jerusalem School of Medicine, Israel; Athanasios Papatsoris, MD, PhD, University of Athens School of Medicine, Greece Received: December 22, 2012; Accepted: March 6, 2013; Published: March 8, 2013 Competing Interests: The authors have declared that no competing interests exist. Copyright: 2013 Aşkın Yıldız et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. * Correspondence to: Aşkın Yıldız, Department of Obstetrics and Gynecology, Izmir Ataturk Training and Research Hospital, Izmir, Turkey. ayild68@yahoo.com
2 Page 2 of 10 Introduction Endometrial cancer (EC) is the most common female gynecologic malignancy, with an estimated annual incidence of per women. The lifetime risk of developing EC is approximately 2.5%, while the lifetime probability of dying from this cancer is estimated at 0.52% [1]. Endometrial carcinoma is surgically staged according to the joint 2010 International Federation of Gynecology and Obstetrics (FIGO)/TNM classification system [2]. Total extrafascial hysterectomy with bilateral salpingo-oophorectomy with pelvic and paraaortic lymph node dissection is the standard staging procedure for endometrial carcinoma [3]. However, no specifications regarding the type and extent of pelvic lymph node dissection have been established. As lymph node metastases can be found in approximately 10% of women who clinically have cancer, removal of all pelvic and para-aortic lymph nodes (lymphadenectomy) is widely advocated. However, the extent (sampling or dissection) and performance of additional para-aortic sampling varies from surgeon to surgeon [4]. Particularly, in patients with a low risk for lymph node metastases (due to superficial depth of invasion, small size of tumour and low tumour grade), a routine lymph node dissection is often not performed. Moreover, substantial co-morbidities such as obesity or old age are considered contraindications to a full pelvic and/or para-aortic lymphadenectomy. Therefore, pelvic and/or para-aortic lymph node dissection has been a subject of continuous debate [5, 6]. Some recent studies have investigated the impact of the extent of lymph node removal in surgical treatment of EC. The results demonstrated an impact on survival for patients with a higher number of dislodged lymph nodes, especially in cases showing high-risk clear-cell or serous-papillary histology [7, 8]. In 2007, a retrospective analysis by the Surveillance Epidemiology and End Results program in the U.S.A. reviewed a large population database and concluded that lymphadenectomy results in improved survival of patients with EC [9, 10]. However, in a recent prospective study, there was no evidence of benefit from pelvic lymphadenectomy in terms of overall or recurrence-free survival in women with early EC [11]. Objectives The aim of this study was to evaluate the outcome of pelvic and/or para-aortic lymph node dissection in patients with EC with regard to lymph node positivity. Materials and Methods Study Design: We retrospectively reviewed the medical records of women with pathologically proven EC who were treated between January 2006 and January Institutional review board approval was obtained in advance for this retrospective study. Patients characteristics, histological findings, lymph node localization and involvement were analyzed. Demographic data including age at diagnosis, body mass index (BMI), parity, presenting symptoms, personal background, and family history were obtained from the archive records. All operations were performed by gynecologic oncologists. All patients underwent surgical staging including washing cytology, total abdominal hysterectomy, bilateral salpingo-oophorectomy, and PLN and/or PALN dissection. The depth of tumour invasion, cervical extension and the tumour diameter were intraoperatively assessed via fresh frozen section of the removed uterus. Bilateral pelvic lymphadenectomy included complete skeletonization of the common, external and internal iliac vessels and the harvesting of all lymphatic tissue in the upper and lower parts of obturator fossa after visualization of the obturator nerve and lumbosacral trunk. The superior surgical margin of dissection for the pelvic nodes was where the ureters cross the common iliac arteries. The anterior distal surgical margin of the pelvic lymphadenectomy was the circumflex iliac vein. The para-aortic lymphadenectomy was performed by mobilizing the paracolic peritoneum along the lateral border of the ascending and descending colon, permitting identification of the proximal ureters and high division of the ovarian vessels. This allowed
3 Page 3 of 10 visualization of the whole retroperitoneum up to the superior borders of the renal veins. All lymphatic tissue was then harvested from the lateral, anterior, and medial aspects of the vena cava and aorta up to the renal veins. Postoperative pathologic specimens were evaluated for tumour stage, histologic type, histologic grade (three grades according to the International Federation of Gynecology and Obstetrics (FIGO) surgical staging system adopted in 2010), and lymph node metastasis (present or absent). Statistical Analysis: Data were analyzed using the Statistical Package for Social Sciences 11.0 for Windows (SPSS Inc., Chicago, IL). The following statistical tests were performed: Chi-square test, t test for independent samples, and the analysis of variance (ANOVA) test. The results for all items were expressed as mean±sd, assessed within a 95% reliance and at a level of p<0.05 significance. (3.2%) of the family members of the study group. Clinical and demographic variables were shown in Table 1. Results The medical records for 125 (mean age 61.49±11.02; range 36 to 85 years) patients were eligible for analysis. All patients underwent surgical staging including washing cytology, total hysterectomy, bilateral salpingo-oophorectomy, and PLN and/or PALN dissection. 21.4% of the cases were in reproductive stage and 88.6% were in postmenopausal stage. Obesity was observed in 10 (8.1%) cases. Mean body mass index was 30.5 kg/m². Multiparity was observed in 106 (84.8%) patients, primiparity was observed in 15 (12%) patients, and nulliparity was observed in 4 (3.2%) patients in the study group. Postmenopausal bleeding was the most common presenting symptom with 64.8% of the patients followed by menometrorrhagia in 16%, inguinal pain in 12%, vaginal discharge in 3.2%, and abdominal distension in 4% of the patients. Personal background of the study group revealed hypertension in 26 (21%) patients, diabetes mellitus in 17 (13.7%) patients and both diabetes mellitus and hypertension in 17 (13.7%) cases. Family history was negative in 120 (96%) patients. Carcinoma was present in 5 (4%) and specifically endometrium carcinoma was present in 4
4 Page 4 of 10 Table 1: Demographic and clinical variables of the patients Variable n (%) Body Mass Index Underweight (<18.5 kg/m²) 4 (3.2%) Normal ( kg/m²) 29 (23.4%) Overweight ( kg/m²) 82 (66.1%) Obese (>30 kg/m²) 10 (8.1%) Parity Nulliparity 4 (3.2%) Primiparity 15 (12%) Multiparity 106 (84.8%) Presenting symptoms Postmenopausal bleeding 81 (64.8%) Menometrorrhagia 20 (16%) Inguinal pain 15 (12%) Vaginal discharge 4 (3.2%) Abdominal distension 5 (4%) Personal background Hypertension 26 (21%) Diabetes mellitus 17 (13.7%) Diabetes mellitus + Hypertension 17 (13.7%) Coronary artery disease 3 (2.4%) Chronic obstructive pulmonary disease 3 (2.4%) Family history Carcinoma 5 (4%) Endometrium carcinoma 4 (3.2%) Breast carcinoma 1 (0.8%) Negative 120 (96%) Detailed description of the extirpated and affected lymph nodes divided by area in the 125 patients with EC was shown in Table 2. The mean number of all lymph nodes removed in operation was 38.9± (range 9 to 81 nodes). The mean number of PLNs removed was 32± (range 9 to 75 nodes) and the mean number of PALNs removed was 7±5.123 (range 0 to 20 nodes).
5 Page 5 of 10 Table 2: Detailed descriptions of the extirpated and affected lymph nodes divided by area in the 125 patients with endometrial cancer Lymph node number Lymph-node areas N-status mean±sd % All region LN N0 38.9± % N+ 1.34±4.084 Total PLN N ± % N+ 1.03±3.365 PALN N0 6.93± % N+ 0.31±1.066 Right external iliac LN N0 5.12± % N+ 0.14±0.605 Left external iliac LN N0 5.01± % N+ 0.18±0.53 Right internal iliac LN N0 2.91± % N+ 0.08±0.413 Left internal iliac LN N0 1.90± % N+ 0.07±0.363 Right common iliac LN N0 4.15± % N+ 0.09±0.492 Left common iliac LN N0 4.42± % N+ 0.14±0.564 Right obturator LN N0 4.49± % N+ 0.19±0.859 Left obturator LN N0 3.96± % N+ 0.13±0.718 LN= Lymph node Nodal metastasis was shown in 24 patients (19.2%) in the study group. Detailed description of the extirpated and affected lymph nodes divided by area in the 24 patients with nodal metastasis was shown in Table 3. The mean number of all lymph nodes removed in operation was 37.88± (range 9 to 81 nodes). The mean number of PLNs removed was 30.71±14.79 (range 9 to 66 nodes) and the mean number of PALNs removed was 7.17±4.198 (range 0 to 16 nodes) (Figure 1). Isolated PLN metastasis was shown in nine (37%) patients; isolated PALN metastasis was shown in one (4%) patient; both PLN and PALN metastasis was shown in 14 (59%) patients. The most affected lymph node area was left external iliac artery with a ratio of 14 percent.
6 Page 6 of 10 Table 3: Detailed descriptions of the extirpated and affected lymph nodes divided by area in the 24 patients with nodal metastasis Lymph node number Lymph-node areas N-status mean±sd % All region LN N ± % N+ 7.00±6.972 Total PLN N ± % N+ 5.38±6.056 PALN N0 7.17± % N+ 1.63±1.974 Right external iliac LN N0 5.04± % N+ 0.75±1.225 Left external iliac LN N0 5.29± % N+ 0.96±0.859 Right internal iliac LN N0 2.38± % N+ 0.42±0.881 Left internal iliac LN N0 1.79± % N+ 0.38±0.77 Right common iliac LN N0 3.46± % N+ 0.46±1.062 Left common iliac LN N0 4.25± % N+ 0.75±1.113 Right obturator LN N0 4.54± % N+ 1.00±1.769 Left obturator LN N0 3.96± % N+ 0.67±1.551 Figure 1: Patients with positive PLNs and PALNs classified according to their localization
7 Page 7 of 10 Postoperative clinical and histopathological findings in the study group were shown in Table 4. Of the 125 patients, 93 (74.4%) were found to be FIGO stage 1 patients while 32 (25.6%) were in advanced stage (FIGO stage 2,3, and 4). Grade of differentiation was Grade 1 in 34 (19.5%) patients, Grade 2 in 123 (70.7%) patients, and Grade 3 in 17 (9.8%) patients. Histological type was adenocarcinoma in 113 (90%) patients, papillary serous carcinoma in 7 (5.6%) patients and clear cell adenocarcinoma in 3 (2.4%) patients. Table 4: Postoperative findings in the study group n (%) Clinical stage (FIGO) Ia 72 (57.6%) Ib 21 (16.8%) II 6 (4.8%) IIIa 2 (1.6%) IIIc1 9 (7.2%) IIIc2 11 (8.8%) IV a 4 (3.3%) Postoperative grade Grade 1 34 (19.5%) Grade (70.7%) Grade 3 17 (9.8%) Histological type Adenocarcinoma 113 (90%) Papillary serous carcinoma 7 (5.6%) Clear cell adenocarcinoma 3 (2.4%) Others 2 (1.6%) Removed total LN Removed PLN and PALN 39 (100%) Removed PLN 32 (82.2%) Removed PALN 7 (17.8%) Removed metastatic LN Removed metastatic PLN and PALN 38 (100%) Removed metastatic PLN 31 (81.1%) Removed metastatic PALN 7 (18.9%) Discussion Despite the unquestionable role of lymph node metastasis in EC, there is a controversy and debate about the therapeutic relevance of systematic lymphadenectomy. The rate of lymph node metastasis in endometrial cancer is usually below 15% [12]. Preoperative assessment of the lymph node involvement represents critical steps for determining the extent of surgery in patients with endometrial carcinoma. If the presence of lymph node metastasis could be predicted accurately before surgery, management plans for patients could be individualized. Earlier protocols defined that a lymph node sampling in the para-aortic region should be performed at least up to the insertion of the inferior mesenteric artery (IMA). However, recent sporadic reports revealed high rates of lymphatic metastasis above the IMA, indicating the need for systematic lymphadenectomy up to the renal vessels, equivalent to the dissection performed for epithelial ovarian cancer [13, 14]. Bakkum-Gamez et al. commented that there is no evidence that inadequate lymphadenectomy is superior to complete exclusion of lymphadenectomy [15]. ASTEC-study group showed no advantage in terms of
8 Page 8 of 10 overall survival for pelvic lymphadenectomy alone in women with early EC [16]. A comparison of the Gynecologic Oncology Group (GOG)-99 (lymphadenectomy performed) and the Post Operative Radiation Therapy in Endometrial Carcinoma (PORTEC)-trials (no lymphadenectomy performed) would also seem to suggest that lymphadenectomy does not affect survival in patients with intermediate-risk tumors confined to the uterus [17-19]. In an assessment of over 400 EC patients, Mariani et al. found that 77% of the patients with para-aortic lymphatic spread had positive lymph nodes in the area above the IMA [13]. Para-aortic lymph node involvement occurs in approximately 7-8 % of EC patients overall and in about 50 % of patients with positive pelvic nodes [20]. In the present analysis we found a considerable high rate of affected PALNs; more than 50% of them presented positive PALNs located above the IMA up to the level of the renal veins. In a study performed by Cragun et al., an association between extensive lymph node dissection (>11 lymph nodes) with a prolonged survival was found in patients they defined as a higher risk group without any macroscopic evidence of metastatic endometrial carcinoma [21]. Kilgore et al. performed selective lymphadenectomies from multiple areas in 649 patients with Stage I disease (average number of lymph nodes, 11). Better survival rates were detected in this group of patients when compared with the patients who hadn t undergone lymphadenectomies [22]. Several expert opinions have explained very improved survival rates achieved in the patients who had undergone extensive lymphadenectomies by the beneficial effect of extensive lymphadenectomy in the planning of adjuvant treatment [23, 24]. Since FIGO introduced surgical staging of EC in 1988, an essential question have remained unanswered: What is the extent of an optimal lymphadenectomy?. In various studies, different number of lymph nodes has been reportedly removed from each site. Benedetti-Panici et al. recommended removal of PLNs, and PALNs during systematic lymphadenectomies [25]. Kitchener et al. reported average number of PLNs, and PALNs removed as 20 (range 14-28), and 123 (range 8-24) respectively [11]. In their study, Köhler et al. estimated average number of PLNs, and PALNs retrieved during systematic lymphadenectomies as 22 (range 16-34), and 14 (range 12-24), respectively [26]. Vergote et al. advised removal of 20 PLNs, and 10 PALNs during systematic lymphadenectomy [27]. In our series consisting of 125 patients, on an average, totally 39 lymph nodes were dissected which comprised of 32 PLNs, and 7 PALNs. In the metastatic lymph node group (n=24 patients) mean number of PLNs and PALNs were found to be 31, and 7 pieces, respectively. In 60% of the cases with affected PLNs, PALN involvement was also detected [27]. In our series of 125 cases (incl. 24 cases with metastatic lymph nodes) who underwent systematic lymphadenectomies, nearly 80% the lymph nodes were distributed in the PLN, and 20% of them in the PALN regions. Lymph nodes were similarly distributed on the right, and the left side of the pelvis. Majority of lymph nodes were detected in the external iliac lymph node region in accordance with the lymphatic distribution, while the least number of lymph nodes were localized in the internal iliac lymph node region, bilaterally. In the endometrial cancer surgery, for the determination of adequate number of lymph nodes, lymph node mapping might guide the surgical approach. The following limitations of the current study must be acknowledged. First, this was a small scale retrospective study, and since the number of our patients was limited, only restricted conclusions can be derived from our data regarding the prognostic impact of lymph node metastases. Conclusions In the field of gynecologic cancer surgery, for the determination of adequate number of lymph nodes to be retrieved, lymph node mapping plays a crucial role, and this issue should be investigated in studies performed with larger number of cases in order to standardize procedure of lymphadenectomy.
9 Page 9 of 10 References 1. Gloeckler Ries LA, Reichman ME, Lewis DR, et al. Cancer survival and incidence from the Surveillance, Epidemiology, and End Results (SEER) program. Oncologist. 2003, 8: American Joint Committee on Cancer. Corpus Uteri. In: AJCC Staging Manual, 7th, Springer, New York p Pecorelli S. Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. Int J Gynaecol Obstet. 2009, 105: Sehouli J, Camara O, Stengel D, et al. Multiinstitutional survey on the value of lymphadenectomy in endometrial carcinoma in Germany. Gynakol Geburtshilfliche Rundsch 2003, 43: Halkia E, Kalinoglou N, Spiliotis J. Surgical management of endometrial cancer. A critical review. J BUON. 2012, 17: Yildiz A, Yetimalar H, Kasap B, Aydin C, Tatar S, Soylu F, Yildiz FS. Preoperative serum CA 125 level in the prediction of the stage of disease inendometrial carcinoma. Eur J Obstet Gynecol Reprod Biol. 2012, 164: Abu-Rustum NR, Iasonos A, Zhou Q, et al. Is there a therapeutic impact to regional lymphadenectomy in the surgical treatment of endometrial carcinoma? Am J Obstet Gynecol. 2008, 198:e Lutman CV, Havrilesky LJ, Cragun JM, et al. Pelvic lymph node count is an important prognostic variable for FIGO stage I and II endometrial carcinoma with high-risk histology. Gynecol Oncol. 2006, 102: 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: Zhang C, Wang C, Feng W. Clinicopathological risk factors for pelvic lymph node metastasis in clinical early-stage endometrioid endometrial adenocarcinoma. Int J Gynecol Cancer. 2012, 22: Kitchener H, Swart AM, Qian Q, et al. Efficacy of systematic pelvic lymphadenectomy in endometrial cancer (MRC ASTEC trial): a randomised study. Lancet 2009, 373: Chan JK, Kapp DS. Role of complete lymphadenectomy in endometrioid uterine cancer. Lancet Oncol. 2007, 8: Mariani A, Dowdy SC, Cliby WA, et al. Prospective assessment of lymphatic dissemination in endometrial cancer: a paradigm shift in surgical staging. Gynecol Oncol. 2008, 109: Eitan R, Abu-RustumNR, Walker JL, et al. Endometrial cancermetastatic to infrarenal aortic lymph-nodes unrecognized during laparoscopic inframesenteric aortic lymph-node dissection. Gynecol Oncol. 2004, 93: Bakkum-Gamez JN, Gonzalez-Bosquet J, Laack NN, et al. Current issues in the management of endometrial cancer. Mayo Clin Proc. 2008, 83: ASTEC Study Group, Kitchener H, Swart AM, et al. Efficacy of systematic pelvic lymphadenectomy in endometrial cancer (MRC ASTEC trial): a randomised study. Lancet. 2009, 373: Keys HM, Roberts JA, Brunetto VL, et al. A phase III trial of surgery with or without adjunctive external pelvic radiation therapy in intermediate risk endometrial adenocarcinoma: a Gynecologic Oncology Group study. Gynecol Oncol. 2004, 92: Creutzberg CL, van Putten WL, Koper PC, et al. Surgery and postoperative radiotherapy versus surgery alone for patients with stage-1 endometrial carcinoma: multicentre randomised trial. PORTEC Study Group. Post Operative Radiation Therapy in Endometrial Carcinoma. Lancet. 2000, 355: Creutzberg CL. GOG-99: ending the controversy regarding pelvic radiotherapy for endometrial carcinoma? Gynecol Oncol. 2004, 92: Alhilli MM, Mariani A. The role of para-aortic lymphadenectomy in endometrial cancer. Int J Clin Oncol Feb 15. [Epub ahead of print]. 21. Cragun JM, Havrilesky LJ, Calingaert B, et al. Retrospective analysis of selective lymphadenectomy in apparent early-stage endometrial cancer. J Clin Oncol. 2005, 23: Kilgore LC, Partridge EE, Alvarez RD, et al. Adenocarcinoma of the endometrium: survival comparisons of patients with and without pelvic node sampling. Gynecol Oncol. 1995, 56:29-33
10 Page 10 of Orr JW Jr, Holimon JL, Orr PF. Stage I corpus cancer: is teletherapy necessary? Am J Obstet Gynecol. 1997, 176: Fanning J. Long-term survival of intermediate risk endometrial cancer (stage IG3, IC, II) treated with full lymphadenectomy and brachytherapy without teletherapy. Gynecol Oncol. 2001, 82: Benedetti Panici P, Basile S, Maneschi F, et al. Systematic pelvic lymphadenectomy vs. no lymphadenectomy in early-stage endometrial carcinoma: randomized clinical trial. J Natl Cancer Inst. 2008, 100: Köhler C, Klemm P, Schau A, et al. Introduction of transperitoneal lymphadenectomy in a gynecologic oncology center: analysis of 650 laparoscopic pelvic and/or paraaortic transperitoneal lymphadenectomies. Gynecol Oncol 2004, 95: Amant F, Neven P, Vergote I. Lymphadenectomy in endometrial cancer. Lancet. 2009, 373:
ENDOMETRIAL CANCER. Endometrial cancer is a great concern in UPDATE. For personal use only. Copyright Dowden Health Media
For mass reproduction, content licensing and permissions contact Dowden Health Media. UPDATE ENDOMETRIAL CANCER Are lymphadenectomy and external-beam radiotherapy valuable in women who have an endometrial
More informationsurgical staging g in early endometrial cancer
Risk adapted d approach to surgical staging g in early endometrial cancer Leon Massuger University Medical Centre St Radboud Nijmegen, The Netherlands Doing nodes Yes Yes Yes No No No 1957---------------------------
More informationChapter 2: Initial treatment for endometrial cancer (including histologic variant type)
Chapter 2: Initial treatment for endometrial cancer (including histologic variant type) CQ01 Which surgical techniques for hysterectomy are recommended for patients considered to be stage I preoperatively?
More informationUpdate on Sentinel Node Biopsy in Endometrial Cancer: Feasibility, Technique, Impact
Update on Sentinel Node Biopsy in Endometrial Cancer: Feasibility, Technique, Impact Bjørn Hagen, MD, PhD St Olavs Hospital Trondheim University Hospital Trondheim, Norway Endometrial Cancer (EC) The most
More informationEndometrial Cancer. Saudi Gynecology Oncology Group (SGOG) Gynecological Cancer Treatment Guidelines
Saudi Gynecology Oncology Group (SGOG) Gynecological Cancer Treatment Guidelines Endometrial Cancer Emad R. Sagr, MBBS, FRCSC Consultant Gynecology Oncology Security forces Hospital, Riyadh Epidemiology
More informationStaging. Carcinoma confined to the corpus. Carcinoma confined to the endometrium. Less than ½ myometrial invasion. Greater than ½ myometrial invasion
5 th of June 2009 Background Most common gynaecological carcinoma in developed countries Most cases are post-menopausal Increasing incidence in certain age groups Increasing death rates in the USA 5-year
More informationRadiation Therapy in Early Endometrial Cancers: Con
Radiation Therapy in Early Endometrial Cancers: Con 106 Jamie N. Bakkum-Gamez, MD Andrea Mariani, MD Karl C. Podratz, MD, PhD Introduction Endometrial cancer (EC) represents a heterogeneous spectrum of
More informationLaparoscopic Management of Early Stage Endometrial Cancer. B. Rabischong, M. Canis, G. Le Bouedec, C. Pomel, J.L Achard, J. Dauplat, G.
Laparoscopic Management of Early Stage Endometrial Cancer B. Rabischong, M. Canis, G. Le Bouedec, C. Pomel, J.L Achard, J. Dauplat, G. Mage Early Stage of Endometrial Cancer most of cases diagnosed (clinical
More informationImpact of Surgery Extent on Survival and Recurrence Rate of Stage ⅠEndometrial Adenocarcinoma
Hou et al. / Cancer Cell Research 3 (2014) 65-69 Cancer Cell Research Available at http:// http://www.cancercellresearch.org/ ISSN 2161-2609 Impact of Surgery Extent on Survival and Recurrence Rate of
More informationRochester Minnesota Mayo Clinic
Are There Still Indications for Lymphadenectomy in Endometrial Cancer? A Mariani Mayo Clinic Rochester - MN USA Rochester Minnesota Mayo Clinic 1 Endometrial Cancer Lymphadenectomy Yes or No? Endometrial
More informationViews and counter views The role of pelvic and para-aortic lymph node dissection in the surgical treatment of endometrial cancer: a view from the USA
The Obstetrician & Gynaecologist 10.1576/toag.11.3.199.27505 http://onlinetog.org 2009;11:199 204 Views and counter views Views and counter views The role of pelvic and para-aortic lymph node dissection
More informationIs Surgical Staging Necessary for Patients with Low-risk Endometrial Cancer? A Retrospective Clinical Analysis
RESEARCH ARTICLE Is Surgical Staging Necessary for Patients with Low-risk Endometrial Cancer? A Retrospective Clinical Analysis Arif Kokcu 1, Emel Kurtoglu 1 *, Handan Celik 1, Mehmet Kefeli 2, Migraci
More informationAdjuvant Therapies in Endometrial Cancer. Emma Hudson
Adjuvant Therapies in Endometrial Cancer Emma Hudson Endometrial Cancer Most common gynaecological cancer Incidence increasing in Western world 1-2% cancer deaths 75% patients postmenopausal 97% epithelial
More informationRisk assessment of lymph node metastasis before surgery in endometrial cancer: Do we need a clinical trial for low-risk patients?
bs_bs_banner doi:10.1111/jog.12281 J. Obstet. Gynaecol. Res. Vol. 40, No. 2: 322 326, February 2014 Risk assessment of lymph node metastasis before surgery in endometrial cancer: Do we need a clinical
More informationStaging and Treatment Update for Gynecologic Malignancies
Staging and Treatment Update for Gynecologic Malignancies Bunja Rungruang, MD Medical College of Georgia No disclosures 4 th most common new cases of cancer in women 5 th and 6 th leading cancer deaths
More informationNew Cancer Cases By Site Breast 28% Lung 14% Colo-Rectal 10% Uterus 6% Thyroid 5% Lymphoma 4% Ovary 3%
Uterine Malignancy New Cancer Cases By Site 2010 Breast 28% Lung 14% Colo-Rectal 10% Uterus 6% Thyroid 5% Lymphoma 4% Ovary 3% Cancer Deaths By Site 2010 Lung 26% Breast 15% Colo-Rectal 9% Pancreas 7%
More informationRelapse Patterns and Outcomes Following Recurrence of Endometrial Cancer in Northern Thai Women
DOI:http://dx.doi.org/10.7314/APJCP.2015.16.9.3861 Relapse Patterns and Outcomes Following Recurrence of Endometrial Cancer in Northern Thai Women RESEARCH ARTICLE Relapse Patterns and Outcomes Following
More informationAbstract. Int J Gynecol Cancer 2007
Int J Gynecol Cancer 2007 Survival impact of lymph node dissection in endometrial adenocarcinoma: a surveillance, epidemiology, and end results analysis D.C. SMITH*, O.K. MACDONALD*, C.M. LEEy & D.K. GAFFNEY*
More informationRisk group criteria for tailoring adjuvant treatment in patients with endometrial cancer : a validation study of the GOG criteria
Risk group criteria for tailoring adjuvant treatment in patients with endometrial cancer : a validation study of the GOG criteria Suk-Joon Chang, MD, Hee-Sug Ryu MD Gynecologic Cancer Center Department
More informationProf. Dr. Aydın ÖZSARAN
Prof. Dr. Aydın ÖZSARAN Adenocarcinomas of the endometrium Most common gynecologic malignancy in developed countries Second most common in developing countries. Adenocarcinomas, grade 1 and 2 endometrioid
More informationreceive adjuvant chemotherapy
Women with high h risk early stage endometrial cancer should receive adjuvant chemotherapy Michael Friedlander The Prince of Wales Cancer Centre and Royal Hospital for Women The Prince of Wales Cancer
More informationSURGICAL ANATOMY OF RETROPERITONEUM AND LYMPHADENECTOMY
SURGICAL ANATOMY OF RETROPERITONEUM AND LYMPHADENECTOMY P. De Iaco S.Orsola-Malpighi Hospital - Bologna Unit Oncological Gynecology PELVIC AND AORTIC LYMPH NODE METASTASIS IN EPITHELIEL OVARIAN CANCER
More informationIntra-operative frozen section analysis of common iliac lymph nodes in patients with stage IB1 and IIA1 cervical cancer
Arch Gynecol Obstet (2012) 285:811 816 DOI 10.1007/s00404-011-2038-z GYNECOLOGIC ONCOLOGY Intra-operative frozen section analysis of common iliac lymph nodes in patients with stage IB1 and IIA1 cervical
More informationSurvival analysis of endometrial cancer patients with cervical stromal involvement
Original Article J Gynecol Oncol Vol. 25, No. 2:105-110 pissn 2005-0380 eissn 2005-0399 Survival analysis of endometrial cancer patients with cervical stromal involvement Jonathan E. Frandsen 1, William
More informationAdjuvant radiotherapy and survival outcomes in early-stage endometrial cancer: A multi-institutional analysis of 608 women
Gynecologic Oncology 103 (2006) 661 666 www.elsevier.com/locate/ygyno Adjuvant radiotherapy and survival outcomes in early-stage endometrial cancer: A multi-institutional analysis of 608 women O. Kenneth
More informationIndex. B Bilateral salpingo-oophorectomy (BSO), 69
A Advanced stage endometrial cancer diagnosis, 92 lymph node metastasis, 92 multivariate analysis, 92 myometrial invasion, 92 prognostic factors FIGO stage, 94 histological grade, 94, 95 histologic cell
More informationTherapeutic Role of Lymph Node Resection in Endometrioid Corpus Cancer. BACKGROUND. The purpose of the current study was to determine the potential
1823 Therapeutic Role of Lymph Node Resection in Endometrioid Corpus Cancer A Study of 12,333 Patients John K. Chan, MD 1 Michael K. Cheung, BA 1 Warner K. Huh, MD 3 Kathryn Osann, PhD 4 Amreen Husain,
More informationPREDICTORS OF LIMPH NODE METASTASIS IN ENDOMETRIAL CANCER
PREDICTORS OF LIMPH NODE METASTASIS IN ENDOMETRIAL CANCER 1, 1, FLORIN LAURENTIU IGNAT, ALEXANDRU IRIMIE, 1, NICOLAE COSTIN, PATRICIU ACHIMAS-CADARIU, IOAN COSMIN LISENCU 1 1 Ion Chiricuta Oncological
More informationOne of the commonest gynecological cancers,especially in white Americans.
Gynaecology Dr. Rozhan Lecture 6 CARCINOMA OF THE ENDOMETRIUM One of the commonest gynecological cancers,especially in white Americans. It is a disease of postmenopausal women with a peak incidence in
More informationParaaortic Lymph Node Dissection
Paraaortic Lymph Node Dissection 가천의대 임소이 Pelvic & paraaortic lymph node dissection Major surgical staging procedure Endometrial cancer, ovarian cancer Cervical cancer: clinical staging Surgical and oncologic
More informationManagement of Endometrial Hyperplasia
Management of Endometrial Hyperplasia I have nothing to disclose. Stefanie M. Ueda, M.D. Assistant Clinical Professor UCSF Division of Gynecologic Oncology Female Malignancies in the United States New
More informationPrognosis and recurrence pattern of patients with cervical carcinoma and pelvic lymph node metastasis
NJOG 2009 June-July; 4 (1): 19-24 Prognosis and recurrence pattern of patients with cervical carcinoma and pelvic lymph node metastasis Eliza Shrestha 1, Xiong Ying 1,2, Liang Li-Zhi 1,2, Zheng Min 1,2,
More informationARRO Case: Early-stage Endometrial Cancer
ARRO Case: Early-stage Endometrial Cancer Ankit Modh, MD (PGY-4) Faculty Advisor: Mohamed A Elshaikh, MD Department of Radiation Oncology Henry Ford Cancer Institute Case Presentation 70 y/o African American
More informationENDOMETRIAL CANCER Updated Apr 2017 by: Dr. Jenny Ko (Medical Oncologist, Abbotsford Cancer Centre)
ENDOMETRIAL CANCER Updated Apr 2017 by: Dr. Jenny Ko (Medical Oncologist, Abbotsford Cancer Centre) Source: UpToDate 2017, ASCO/CCO/Alberta provincial guidelines, NCCN Reviewed by: Dr. Sarah Glaze (Gynecologic
More informationIncidence and Clinical Outcomes of Non-endometrioid Carcinoma of Endometrium: Siriraj Hospital Experience
RESEARCH ARTICLE Incidence and Clinical Outcomes of Non-endometrioid Carcinoma of Endometrium: Siriraj Hospital Experience Atthapon Jaishuen 1, Kate Kunakornporamat 1, Boonlert Viriyapak 1, Mongkol Benjapibal
More informationImplementation of laparoscopic surgery for endometrial cancer: work in progress
FACTS VIEWS VIS OBGYN, 216, 8 (1): - Original paper Implementation of laparoscopic surgery for endometrial cancer: work in progress A.A.S. VAN DEN BOSCH 1, H.J.M.M. MERTENS 2 1 Junior-resident, Zuyderland
More informationRESEARCH ARTICLE. Usanee Chatchotikawong 1, Irene Ruengkhachorn 1 *, Chairat Leelaphatanadit 1, Nisarat Phithakwatchara 2. Abstract.
RESEARCH ARTICLE 8-year Analysis of the Prevalence of Lymph Nodes Metastasis, Oncologic and Pregnancy Outcomes in Apparent Early-Stage Malignant Ovarian Germ Cell Tumors Usanee Chatchotikawong 1, Irene
More informationLymphovascular space invasion in early-stage endometrial cancer: adjuvant treatment and patterns of recurrence
Southern 10 African African Journal Journal of Gynaecological of Gynaecological Oncology Oncology 2016; 8(1):10-15 2016; 1(1):1 6 http://dx.doi.org/10.1080/20742835.2016.1175708 Open Access article article
More informationPort-Site Metastases After Robotic Surgery for Gynecologic Malignancy
SCIENTIFIC PAPER Port-Site Metastases After Robotic Surgery for Gynecologic Malignancy Noah Rindos, MD, Christine L. Curry, MD, PhD, Rami Tabbarah, MD, Valena Wright, MD ABSTRACT Background and Objectives:
More informationMarkers HE4 and CA125 to Predict
Original Article Utility of Pelvic MRI and Tumor Markers HE4 and CA125 to Predict Depth of Myometrial Invasion and Cervical Involvement in Endometrial Cancer Narges Zamani; M.D. 1, Mitra Modares Gilani;
More informationOriginal Date: June 2013 ENDOMETRIAL CANCER
National Imaging Associates, Inc. Clinical guidelines Original Date: June 2013 ENDOMETRIAL CANCER Page 1 of 6 Radiation Oncology Last Review Date: July 2018 Guideline Number: NIA_CG_129 Last Revised Date:
More informationFactors predictive of myoinvasion in cases of Complex Atypical Hyperplasia diagnosed on endometrial biopsy or curettage
Factors predictive of myoinvasion in cases of Complex Atypical Hyperplasia diagnosed on endometrial biopsy or curettage Jessica Johns, MD Jeffrey Killeen, MD Robert Kim, MD Hyeong Jun Ahn, PhD None Disclosures
More informationDefinition of Synoptic Reporting
Definition of Synoptic Reporting The CAP has developed this list of specific features that define synoptic reporting formatting: 1. All required cancer data from an applicable cancer protocol that are
More informationCervical Cancer 3/25/2019. Abnormal vaginal bleeding
Cervical Cancer Abnormal vaginal bleeding Postcoital, intermenstrual or postmenopausal Vaginal discharge Pelvic pain or pressure Asymptomatic In most patients who are not sexually active due to symptoms
More information7. Cytoreductive surgery in endometrial cancer and uterine sarcomas
Transworld Research Network 37/661 (2), Fort P.O. Trivandrum-695 023 Kerala, India Cytoreductive Surgery in Gynecologic Oncology: A Multidisciplinary Approach, 2010: 123-151 ISBN: 978-81-7895-484-4 Editor:
More informationNorth of Scotland Cancer Network Clinical Management Guideline for Endometrial Cancer
THIS DOCUMENT North of Scotland Cancer Network Clinical Management Guideline for Endometrial Cancer Based on WOSCAN CMG with further extensive consultation within NOSCAN UNCONTROLLED WHEN PRINTED DOCUMENT
More informationManagement of high risk early cervical cancer - a view of surgeon Dan DY Kim, M.D., Ph.D.
Management of high risk early cervical cancer - a view of surgeon Dan DY Kim, M.D., Ph.D. Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
More informationMichael G. Kelly, MD Gynecologic Oncologist University of Colorado Cancer Center
Michael G. Kelly, MD Gynecologic Oncologist University of Colorado Cancer Center 50 yo healthy postmenopausal female with BMI = 35 with screening PAP smear = AGUS. What is the next step? (1) Colposcopy
More informationRetrospective evaluation of clinical and pathological features, as well as diagnostic and treatment protocols of primary vaginal malignancy
ORIGINAL PAPER / GYNECOLOGY Ginekologia Polska 2016, vol. 87, no. 8, 541 545 Copyright 2016 Via Medica ISSN 0017 0011 DOI: 10.5603/GP.2016.0041 Retrospective evaluation of clinical and pathological features,
More informationShina Oranratanaphan, Tarinee Manchana*, Nakarin Sirisabya
Comparison of Synchronous Endometrial and Ovarian Cancers versus Primary with Metastasis RESEARCH COMMUNICATION Clinicopathologic Variables and Survival Comparison of Patients with Synchronous Endometrial
More informationEndometrial Cancer. Incidence. Types 3/25/2019
Endometrial Cancer J. Anthony Rakowski DO, FACOOG MSU SCS Board Review Coarse Incidence 53,630 new cases yearly 8,590 deaths yearly 4 th most common malignancy in women worldwide Most common GYN malignancy
More informationTOC NCCN Categories of Evidence and Consensus Category 1: Based upon high-level evidence, there is uniform NCCN consensus that the intervention is appropriate. Category 2A: Based upon lower-level evidence,
More informationCase Scenario 1. History
History Case Scenario 1 A 53 year old white female presented to her primary care physician with post-menopausal vaginal bleeding. The patient is not a smoker and does not use alcohol. She has no family
More informationIn this Update, I report on the latest US
UPDATE Gynecologic cancer Jason D. Wright, MD Dr. Wright is Sol Goldman Associate Professor, Chief of Division of Gynecologic Oncology, Vice Chair of Academic Affairs, Department of Obstetrics and Gynecology,
More informationChemotherapy or Observation in Stage I-II Intermediate or High Risk Endometrial Cancer
Find Studies About Studies Submit Studies Resources About Site Chemotherapy or Observation in Stage I-II Intermediate or High Risk Endometrial Cancer The safety and scientific validity of this study is
More informationC ORPUS UTERI C ARCINOMA STAGING FORM (Carcinosarcomas should be staged as carcinomas)
CLINICAL C ORPUS UTERI C ARCINOMA STAGING FORM PATHOLOGIC Extent of disease before S TAGE C ATEGORY D EFINITIONS Extent of disease through any treatment completion of definitive surgery y clinical staging
More informationPreoperative serum CA125: a useful marker for surgical management of endometrial cancer
Jiang et al. BMC Cancer (2015) 15:396 DOI 10.1186/s12885-015-1260-7 RESEARCH ARTICLE Open Access Preoperative serum CA125: a useful marker for surgical management of endometrial cancer Tao Jiang *, Ling
More informationSLN Mapping in Cervical Cancer. Memorial Sloan Kettering Cancer Center New York, USA
Lead Grou p Log SLN Mapping in Cervical Cancer Nadeem R. Abu-Rustum, M.D. Memorial Sloan Kettering Cancer Center New York, USA Conflict of Interest Disclosure Nadeem R. Abu-Rustum, M.D. I have no financial
More informationPre-operative Evaluation and Implications
Pre-operative Evaluation and Implications Michal Zikan Gynecologic Oncology Center Charles University in Prague, First Faculty of Medicine No recommendation for screening of EC (HNPCC annual biopsies starting
More informationAn Unusual Case of Cervical Cancer with Inguinal Lymph Node Metastasis: A Case Report and Review of the Literature
Archives of Clinical and Medical Case Reports doi: 10.26502/acmcr.9655003 Volume 1, Issue 1 Case Report An Unusual Case of Cervical Cancer with Inguinal Lymph Node Metastasis: A Case Report and Review
More informationARROCase: Locally Advanced Endometrial Cancer
ARROCase: Locally Advanced Endometrial Cancer Charles Vu, MD (PGY-3) Faculty Advisor: Peter Y. Chen, MD, FACR Beaumont Health (Royal Oak, MI) November 2016 Case 62yo female with a 3yr history of vaginal
More informationUTERINE SARCOMAS CURRENT THERAPEUTIC OPTIONS
Review Journal of Translational Medicine and Research, volume 19, no. 1-2, 2014 UTERINE SARCOMAS CURRENT THERAPEUTIC OPTIONS N. Bacalbaæa 1, A. Traistaru 2, I. Bãlescu 3 1 Carol Davila University of Medicine
More informationChapter 8 Adenocarcinoma
Page 80 Chapter 8 Adenocarcinoma Overview In Japan, the proportion of squamous cell carcinoma among all cervical cancers has been declining every year. In a recent survey, non-squamous cell carcinoma accounted
More informationABSTRACT AJCP /ORIGINAL ARTICLE
Assessment of the Intraoperative Consultation Service Rendered by General Pathologists in a Scenario Where a Well-Defined Decision Algorithm Is Followed Mahmoud A. Khalifa, MD, PhD, 1 Sherine Salama, MD,
More informationRole and extension of lymph node dissection in kidney, bladder and prostate cancer. Omar Ghanem (PGY3 ) Moderator: Dr A. Noujem 30 th March 2017
Role and extension of lymph node dissection in kidney, bladder and prostate cancer Omar Ghanem (PGY3 ) Moderator: Dr A. Noujem 30 th March 2017 Bladder Cancer LN dissection in Bladder cancer 25% of patients
More informationICRT รศ.พญ.เยาวล กษณ ชาญศ ลป
ICRT รศ.พญ.เยาวล กษณ ชาญศ ลป Brachytherapy การร กษาด วยร งส ระยะใกล Insertion การสอดใส แร Implantation การฝ งแร Surface application การวางแร physical benefit of brachytherapy - very high dose of radiation
More informationJournal of Clinical Review & Case Reports
Research Article Journal of Clinical Review & Case Reports Prevention of Lymphatic Complications after Pelvic Laparoscopic Lymphadenectomy by Microporous Polysaccharide Absorbable Hemostat MV Gavrilov
More informationMPH Quiz. 1. How many primaries are present based on this pathology report? 2. What rule is this based on?
MPH Quiz Case 1 Surgical Pathology from hysterectomy performed July 11, 2007 Final Diagnosis: Uterus, resection: Endometrioid adenocarcinoma, Grade 1 involving most of endometrium, myometrial invasion
More informationUpdate on sentinel node mapping in uterine cancer: 10-year experience at Memorial Sloan Kettering Cancer Center
bs_bs_banner doi:10.1111/jog.12227 J. Obstet. Gynaecol. Res. Vol. 40, No. 2: 327 334, February 2014 Update on sentinel node mapping in uterine cancer: 10-year experience at Memorial Sloan Kettering Cancer
More informationGynecologic Cancer Surveillance and Survivorship: Informing Practice and Policy
Gynecologic Cancer Surveillance and Survivorship: Informing Practice and Policy Stephanie Yap, M.D. University Gynecologic Oncology Northside Cancer Institute Our Learning Objectives Review survival rates,
More informationShould the Optimal Adjuvant Treatment for Patients With Early-Stage Endometrial Cancer With High-Intermediate Risk Factors Depend on Tumor Grade?
ORIGINAL STUDY Should the Optimal Adjuvant Treatment for Patients With Early-Stage Endometrial Cancer With High-Intermediate Risk Factors Depend on Tumor Grade? Chunyan Lan, MD,* Xin Huang, MD,* Qidan
More informationAdjuvant Radiotherapy in Endometrial Carcinoma David T. Shaeffer and Marcus E. Randall. doi: /theoncologist
Adjuvant Radiotherapy in Endometrial Carcinoma David T. Shaeffer and Marcus E. Randall The Oncologist 2005, 10:623-631. doi: 10.1634/theoncologist.10-8-623 The online version of this article, along with
More informationPreoperative assessment in endometrial cancer. Is triage for lymphadenectomy possible?
JBUON 2017; 22(1): 34-43 ISSN: 1107-0625, online ISSN: 2241-6293 www.jbuon.com E-mail: editorial_office@jbuon.com ORIGINAL ARTICLE Preoperative assessment in endometrial cancer. Is triage for lymphadenectomy
More informationTherapeutic role of systematic lymphadenectomy in early-stage endometrial cancer: A systematic review
ONCOLOGY LETTERS 11: 3849-3857, 2016 Therapeutic role of systematic lymphadenectomy in early-stage endometrial cancer: A systematic review MEI YI LI 1,2, XIAO XIA HU 1, JIAN HONG ZHONG 3, LU LU CHEN 1
More informationPRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES GYNECOLOGIC CANCER CERVIX
PRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES GYNECOLOGIC CANCER CERVIX Site Group: Gynecology Cervix Author: Dr. Stephane Laframboise 1. INTRODUCTION 3 2. PREVENTION 3 3. SCREENING AND
More informationSCIENTIFIC PAPER ABSTRACT INTRODUCTION PATIENTS AND METHODS
SCIENTIFIC PAPER Laparoscopic Transperitoneal Infrarenal Para-Aortic Lymphadenectomy in Patients with FIGO Stage IB1-II B Cervical Carcinoma Dae G. Hong, MD, PhD, Nae Y. Park, MD, Gun O. Chong, MD, Young
More informationUTERINE SARCOMA EXAMPLE OF A UTERINE SARCOMA USING PROPOSED TEMPLATE
UTERINE SARCOMA EXAMPLE OF A UTERINE SARCOMA USING PROPOSED TEMPLATE Case: Adenosarcoma with heterologous elements and stromal overgrowth o TAH, BSO, omentectomy, staging biopsies of cul-de-sac, bladder
More informationPost operative Radiotherapy in Carcinoma Endometrium - KMIO Experience (A Retrospective Study)
Post operative Radiotherapy in Carcinoma Endometrium - KMIO Experience (A Retrospective Study) Sridhar.P, M.D. 1, Sruthi.K, M.D. 2, Naveen.T, M.D. 3, Siddanna.R.P, M.D. 4 Department of Radiation Oncology,
More informationJanjira Petsuksiri, M.D
GYN malignancies Janjira Petsuksiri, M.D Outlines Cervical cancer Endometrial cancer Ovarian cancer Vaginal cancer Vulva cancer 2 CA Cervix Epidemiology - Second most common female cancer Risk factors
More informationLymphovascular Invasion Is a Significant Predictor for Distant Recurrence in Patients With Early-Stage Endometrial Endometrioid Adenocarcinoma
Anatomic Pathology / LVI in Endometrial Cancer Lymphovascular Invasion Is a Significant Predictor for Distant Recurrence in Patients With Early-Stage Endometrial Endometrioid Adenocarcinoma Sharon Nofech-Mozes,
More informationCharacteristics and prognosis of coexisting adnexa malignancy with endometrial cancer: a single institution review of 51 cases
Arch Gynecol Obstet (2011) 283:1133 1137 DOI 10.1007/s00404-010-1574-2 GYNECOLOGIC ONNCOLOGY Characteristics and prognosis of coexisting adnexa malignancy with endometrial cancer: a single institution
More information29 Cancer of the Uterine Corpus
29 Cancer of the Uterine Corpus Robbert Soeters INTRODUCTION Malignancies affecting the uterine corpus are endometrial adenocarcinoma and uterine sarcomas. ENDOMETRIAL ADENOCARCINOMA Endometrial adenocarcinoma
More informationC ORPUS UTERI C ARCINOMA STAGING FORM (Carcinosarcomas should be staged as carcinomas)
C ORPUS UTERI C ARCINOMA STAGING FORM CLINICAL Extent of disease before any treatment y clinical staging completed after neoadjuvant therapy but before subsequent surgery Tis * T1 I T1a IA NX N0 N1 N2
More informationPrognostic significance of positive lymph node number in early cervical cancer
1052 Prognostic significance of positive lymph node number in early cervical cancer JUNG WOO PARK and JONG WOON BAE Department of Obstetrics and Gynecology, Dong A University Hospital, Dong A University
More informationThe Role of Comprehensive Surgical Staging in Patients With Endometrial Cancer
The effects of surgical staging in endometrial cancer on overall survival, utilization of radiation therapy, and impact on quality of life are discussed. Marguerite Bride. Barn Light. Watercolor, 12 18.
More informationCervical Cancer: 2018 FIGO Staging
Cervical Cancer: 2018 FIGO Staging Jonathan S. Berek, MD, MMS Laurie Kraus Lacob Professor Stanford University School of Medicine Director, Stanford Women s Cancer Center Senior Scientific Advisor, Stanford
More informationComplete Pelvic Lymphadenectomy in Patients with Clinical Early, Grade I and II Endometrioid Corpus Cancer
Complete Pelvic Lymphadenectomy in Patients with Clinical Early, Grade I and II Endometrioid Corpus Cancer STELIOS FOTIOU 1, EDWARD L. TRIMBLE 3, KATERINA PAPAKONSTANTINOU 1, AGATHA KONDI-PAFITI 2, THEO
More information2009 USCAP Gyn Pathology Evening Session Case #3. Richard J. Zaino, MD Hershey Medical Center Penn State University Hershey, PA
2009 USCAP Gyn Pathology Evening Session Case #3 Richard J. Zaino, MD Hershey Medical Center Penn State University Hershey, PA rzaino@psu.edu Clinical history Middle aged woman with an exophytic mass of
More informationNorth of Scotland Cancer Network Clinical Management Guideline for Carcinoma of the Uterine Cervix
THIS DOCUMENT North of Scotland Cancer Network Carcinoma of the Uterine Cervix UNCONTROLLED WHEN PRINTED DOCUMENT CONTROL Prepared by A Kennedy/AG Macdonald/Others Approved by NOT APPROVED Issue date April
More informationHysterectomy : A Clinicopathologic Correlation
Bahrain Medical Bulletin, Vol. 28, No.2, June 2006 Hysterectomy : A Clinicopathologic Correlation Layla S Abdullah, FRCPC* Objective : To study the most common pathologies identified in hysterectomy specimens
More information3/25/2019. Rare uterine cancers ~3% Leiomyosarcoma Carcinosarcoma (MMMT) Endometrial Stromal Sarcomas Aggressive tumors High Mortality Rates
J. Anthony Rakowski D.O., F.A.C.O.O.G. MSU SCS Board Review Coarse Rare uterine cancers ~3% Leiomyosarcoma Carcinosarcoma (MMMT) Endometrial Stromal Sarcomas Aggressive tumors High Mortality Rates Signs
More informationNAACCR Webinar Series /7/17
COLLECTING CANCER DATA: UTERUS 2017 2018 NAACCR WEBINAR SERIES Q&A Please submit all questions concerning webinar content through the Q&A panel. Reminder: If you have participants watching this webinar
More informationQuiz. b. 4 High grade c. 9 Unknown
Quiz 1. 10/11/12 CT scan abdomen/pelvis: Metastatic liver disease with probable primary colon malignancy. 10/17/12 Colonoscopy with polypectomy: Adenocarcinoma of sigmoid colon measuring at least 6 mm
More informationRole of peritoneal washing cytology in ovarian malignancies: correlation with histopathological parameters
Naz et al. World Journal of Surgical Oncology (2015) 13:315 DOI 10.1186/s12957-015-0732-1 WORLD JOURNAL OF SURGICAL ONCOLOGY RESEARCH Open Access Role of peritoneal washing in ovarian malignancies: correlation
More informationCan the Ovaries be preserved in Selected Cases of Endometrial Cancer?
Can the Ovaries be preserved in Selected Cases of Endometrial Cancer? Parekh C D 1*, Desai A D 2, Patel B M 3, Patel S M 4, Mankad M H 5 1 Assistant Professor,Department of Gynaecologic Oncology, Gujarat
More informationEndometrial Cancer. GYNE/ONC Practice Guideline. Approval Date: April 4, 2011 V2.5
Endometrial Cancer GYNE/ONC Practice Guideline Approval Date: April 4, 2011 V2.5 This guideline is a statement of consensus of the Gynecologic Oncology Disease Site Team regarding their views of currently
More informationPrognostic factors in adult granulosa cell tumors of the ovary: a retrospective analysis of 80 cases
J Gynecol Oncol Vol. 20, No. 3:158-163, September 2009 DOI:10.3802/jgo.2009.20.3.158 Original Article Prognostic factors in adult granulosa cell tumors of the ovary: a retrospective analysis of 80 cases
More informationControversies in the management of early endometrial carcinoma: an update
International Journal of Reproduction, Contraception, Obstetrics and Gynecology Reddi PR et al. Int J Reprod Contracept Obstet Gynecol. 2017 Jun;6(6):2124-2131 www.ijrcog.org DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20172301
More informationOvarian Transposition for Stage Ib Squamous Cell Cervical Cancer - Lack of Effects on Survival Rates?
DOI:http://dx.doi.org/10.7314/APJCP.2013.14.1.133 RESEARCH ARTICLE Ovarian Transposition for Stage Ib Squamous Cell Cervical Cancer - Lack of Effects on Survival Rates? A Taner Turan 1, H Levent Keskin
More informationThe International Federation of Gynecology and Obstetrics (FIGO) updated the staging
Continuing Education Column Revised FIGO Staging System Hee Sug Ryu, MD Department of Obstetrics and Gynecology, Ajou University School of Medicine E - mail : hsryu@ajou.ac.kr J Korean Med Assoc 2010;
More information