Advances in management of nonendometrioid endometrial carcinoma, with an emphasis on the sentinel lymph node technique

Abstract

Purpose of reviewDuring the last few years there have been important advances in our understanding of endometrial cancer biology, staging, and therapy. In this article, we discuss updates and controversies in the treatment of nonendometrioid endometrial carcinoma (non-EEC), with an emphasis on the role of sentinel lymph node (SLN) biopsy. Recent findingsLymph node involvement is an important factor in determining prognosis and guiding adjuvant therapy in endometrial carcinoma. SLN biopsy has emerged as a less morbid alternative to lymphadenectomy in surgical staging, and it has generally gained acceptance in the setting of low-grade endometrial carcinoma; however, its role in the setting of high-grade disease remains a topic of debate. Several prospective studies have demonstrated the accuracy of SLN biopsy in detecting nodal metastasis in highgrade endometrial carcinoma. Retrospective series have compared oncologic outcomes of patients with high-grade disease, surgically staged by SLN biopsy, to those staged with lymphadenectomy, and have reported similar survival outcomes. Prospective data on survival is lacking. SummaryCurrently, there is sufficient data to support the diagnostic accuracy of SLN biopsy in the surgical staging of non-EEC. The retrospective evidence demonstrates similar survival for SLN biopsy versus lymphadenectomy.

Effect of 3D laparoscopy versus traditional laparotomy on serum tumor markers and coagulation function in patients with early-stage endometrial cancer

“… 13 However, traditional laparotomy often subjects patients to pronounced trauma and increased postoperative complications, adversely affecting their prognosis. 14 Though laparoscopic surgery promises reduced patient trauma and fewer postoperative complications, it suffers from a limited spatial orientation and depth perception, rendering it challenging. 15 , 16 …”

Prevalence of Hypertension and Associated Co-Morbidities in Pakistan

“…According to the Pakistan national blindness and visual impairment survey 2003, 15% of diabetic patients have retinopathy, and their risks were higher in hypertensive diabetic patients. Hypertension is also responsible for causing renal failure and retinopathy [24]. Diabetic retinopathy is usually observed in patients with diabetes mellitus [25].…”

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“…Lymphatic drainage of different organs is complex and SLN localization biopsy is skillful; therefore, the surgeon needs 20-40 practices to master the technique and successfully perform at least 10 SLN operations every year (19)(20)(21). During the learning process, the learning curve of the physician's operational proficiency will affect the success rate of the SLN.…”