Diagnostic Usefulness of Intraoperative Ultrasonography in Avoiding Unnecessary Para-Aortic Lymphadenectomy in Women With Endometrial Carcinoma

Ryo, Eiji; Yasugi, Toshiharu; Mizutani, Katsumi; Kita, Toru; Takeshita, Shigeki; Ayabe, Tokiyoshi

doi:10.1097/igc.0b013e31821a35ef

Cited by 8 publications

(10 citation statements)

References 15 publications

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“…In this article, Ryo et al [ 41 ] evaluated the usefulness of CT, intraoperative ultrasonography and intrauterine pathologic findings in reducing the number of unnecessary para-aortic lymphadenectomies in women with endometrial cancer. The authors reported a sensitivity of 38.9% and a specificity of 100% for CT (Table 3) based on a population of 91 patients, 18 of whom had PAN metastases.…”

Section: Resultsmentioning

confidence: 99%

“…No article met the inclusion criteria. Ryo et al [ 41 ] evaluated lymph nodes by ultrasonography; however this was done intraoperatively rather than preoperatively.…”

Section: Resultsmentioning

confidence: 99%

“…With its sensitivity of 38.9% and specificity of 100%, CT is a poor diagnostic tool for evaluating lymph node status in patients with endometrial cancer [ 41 ] . No conclusions can be drawn for MRI and ultrasonography and the position of PET/(CT) in the diagnostic arsenal is unclear.…”

Section: Discussionmentioning

confidence: 99%

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Diagnostic accuracy of preoperative tests for lymph node status in endometrial cancer: a systematic review

et al. 2013

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Background: Approximately 72% of endometrial cancers are FIGO stage I at diagnosis and about 10% have lymph node metastases. An ideal diagnostic test for nodal disease would be able to prevent both overtreatment (i.e. unnecessary lymphadenectomy) and undertreatment (i.e. withholding lymphadenectomy or adjuvant postoperative treatment to patients with lymph node metastases). Objectives: In this review we compare the accuracy of preoperative tests (computed tomography, magnetic resonance imaging, positron emission tomography-computed tomography, CA-125 serum levels, and ultrasonography) for the detection of lymph node metastases in endometrial cancers with the final histopathologic diagnosis after complete pelvic and para-aortic lymphadenectomy as the gold standard. Method: A systematic search in MEDLINE (using PubMed), Embase and The Cochrane Library was performed up to 23 July 2012. Results: We found one article that met our inclusion criteria for computed tomography, none for magnetic resonance imaging, 2 for positron emission tomography/computed tomography), 2 for CA-125 and none for ultrasonography. Conclusions: Due to the lack of high-quality articles on a preoperative test for lymph node status in endometrial cancer, no proper comparison between these modalities can be made.

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Section: Resultsmentioning

confidence: 99%

“…No article met the inclusion criteria. Ryo et al [ 41 ] evaluated lymph nodes by ultrasonography; however this was done intraoperatively rather than preoperatively.…”

Section: Resultsmentioning

confidence: 99%

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Diagnostic accuracy of preoperative tests for lymph node status in endometrial cancer: a systematic review

et al. 2013

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“…IU is free from the interference of air‐containing organs such as the bowel, lungs, and trachea, and yields high‐quality images. In addition to detecting small lesions, surgeons have applied this technique to identify locoregional lymph nodes in several malignancies . This pilot study was performed to explore the safety, accuracy, and characteristics of IU for identifying RLN lymph nodes in patients with thoracic esophageal cancer.…”

Section: Introductionmentioning

confidence: 99%

Intraoperative ultrasonography for the identification of thoracic recurrent laryngeal nerve lymph nodes in patients with esophageal cancer

Yang

Wang

Zheng

et al. 2016

Diseases of the Esophagus

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The rate of vocal cord palsy following resection for esophageal carcinoma has increased due to lymphadenectomy around the recurrent laryngeal nerves (RLN). The aim of this pilot study was to assess the ability of intraoperative ultrasonography to detect thoracic RLN node metastases in patients with esophageal cancer. Intraoperative ultrasonography was performed during esophagectomy to assess whether RLN lymph nodes were metastatic in 10 patients with esophageal squamous cell cancer. All patients underwent RLN lymphadenectomy, and the nodes were assessed for metastasis. Three patients had pathological RLN lymph node metastases, of which one had right RLN node metastasis, and three had left RLN node metastases. For detecting right RLN lymph node metastasis, the sensitivity, specificity, and positive and negative predictive values of intraoperative ultrasonography were 100%, 33.3%, 14.3%, and 100%, respectively. For the detection of left RLN lymph node, these values were 100%, 85.7%, 75%, and 100%, respectively. This study suggests that intraoperative ultrasonography is feasible and safe to detect RLN lymph node metastases for patients with esophageal cancer. Further study will be performed to evaluate the validity and utility of this diagnostic technique.

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“…IU had superior negative predictive value and sensitivity for para-aortic node metastases. In addition, IU was the most useful diagnostic tool for avoiding unnecessary para-aortic lymphadenectomy in women with endometrial carcinoma [9].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of intraoperative ultrasonography for para-aortic lymph nodes in preventing unnecessary lymphadenectomy in ovarian carcinoma

Ryo¹,

Kita²,

Yasugi

et al. 2013

OJOG

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Objective: To evaluate the usefulness of intraoperative ultrasonography (IU) for para-aortic nodes to identify women who do not require pelvic and paraaortic lymphadenectomy in ovarian carcinoma. Methods: Computed tomography (CT) was used for assessing both pelvic and para-aortic lymph nodes, and IU only for para-aortic nodes in 87 women with ovarian carcinoma. All women underwent surgery with routine systematic pelvic and para-aortic lymphadenectomy. We assumed that no lymphadenectomy had been performed when no enlarged node was detected by either CT or IU or when the woman was in T1 stage. Under these assumptions, the numbers of women who would have had missed metastases and who could have avoided lymphadenectomy were counted. These figures were recounted on the combination of T stage and IU. Results: A total of 22 women had pathological node metastases. The numbers of women with missed metastases on the basis of CT, IU, and T stage were 12, 2, 5, and these who could have avoided lymphadenectomy were 72, 39, and 49, respectively. There were more women avoiding lymphadenectomy by CT than IU and T stage; however, more women with missed node metastases. Both numbers were not significantly different between IU and T stage. On the combination of T stage and IU, 29 of 49 women in T1 stage could have avoided lymphadenectomy without missed metastases. Conclusions: IU for the para-aortic node is a useful method for identifying women who do not require lymphadenectomy for T1 stage ovarian carcinoma.

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Diagnostic Usefulness of Intraoperative Ultrasonography in Avoiding Unnecessary Para-Aortic Lymphadenectomy in Women With Endometrial Carcinoma

Abstract: Intraoperative ultrasonography is the most efficient method for avoiding both unnecessary para-aortic lymphadenectomy and missed para-aortic node metastases in women with endometrial carcinoma.

Cited by 8 publications

References 15 publications

Diagnostic accuracy of preoperative tests for lymph node status in endometrial cancer: a systematic review

Diagnostic accuracy of preoperative tests for lymph node status in endometrial cancer: a systematic review

Intraoperative ultrasonography for the identification of thoracic recurrent laryngeal nerve lymph nodes in patients with esophageal cancer

Effectiveness of intraoperative ultrasonography for para-aortic lymph nodes in preventing unnecessary lymphadenectomy in ovarian carcinoma

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