Hysterectomy with extended surgical staging and radiotherapy versus hysterectomy alone and radiotherapy in stage I endometrial cancer: A comparison of complication rates

Lewandowski, George; Torrisi, J.; Potkul, R K; Holloway, PW; Popescu, G.; Whitfield, G.; Delgado, Gabriela Neves

doi:10.1016/0020-7292(91)90593-t

Cited by 9 publications

(10 citation statements)

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“…Adjuvant therapy for patients with early‐stage endometrial carcinoma usually consists of radiation therapy. The reported rates of toxicity or serious toxicity associated with radiation therapy range from 7% to 20% 14, 20–22. A marker to identify those patients who are at a very low risk of recurrence could be used to avoid unnecessary adjuvant therapy and lessen the morbidity and expense associated with treating endometrial carcinoma.…”

Section: Discussionmentioning

confidence: 99%

Ribosomal DNA methylation in patients with endometrial carcinoma

Powell

Mutch

Rader

et al. 2002

Cancer

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Section: Discussionmentioning

confidence: 99%

Ribosomal DNA methylation in patients with endometrial carcinoma

Powell

Mutch

Rader

et al. 2002

Cancer

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“…The current trend for adjuvant radiotherapy in endometrial carcinoma is to treat patients with deep myometrial invasion (International Federation of Gynecology and Obstetrics [FIGO] Stage IC), irrespective of tumor grade or in the absence of deep myoinvasion (FIGO Stage IB), with poorly differentiated tumors (Grade 3). However, it is known that radiotherapy‐related morbidity increases dramatically after pelvic and aortic lymphadenectomy 35. In addition, the elderly patients are particularly prone to complications from pelvic irradiation due to the prevalence of bowel diverticula and intestinal adhesions.…”

Section: Discussionmentioning

confidence: 99%

Systematic pelvic and aortic lymphadenectomy in elderly gynecologic oncologic patients

Giannice

Susini

Ferrandina

et al. 2001

Cancer

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BACKGROUND Retroperitoneal lymph node dissection is a fundamental step in the surgical management of patients with pelvic gynecologic malignancies, but its applicability to geriatric patients is controversial. The objective of this study was to evaluate whether pelvic and aortic lymphadenectomy in elderly patients with gynecologic malignancies can be a safe procedure in terms of morbidity and mortality. METHODS In a retrospective case–control study, the authors compared morbidity, mortality, and surgical data in a series of elderly patients (age > 70 years) with endometrial and ovarian carcinoma who underwent surgery. Patients were divided into two groups: Cases were 36 elderly patients who underwent surgery and pelvic and/or aortic lymphadenectomy and were matched with 72 controls, who were patients who underwent surgery without lymphadenectomy. RESULTS Cases showed a significantly longer median operative time than controls (median, 162 minutes [range, 85–330 minutes] vs. median, 100 minutes [range 20–310 minutes], respectively; P = 0.003). No significant difference between the two groups in terms of blood loss, blood transfusions, intraoperative complications, duration of ileus, reintervention required, or postoperative hospital stay were observed. One patient in the control group died. The type and frequency of severe postoperative complications in the two groups were not substantially different. CONCLUSIONS Pelvic and aortic lymphadenectomy was performed safely in elderly patients age ≥ 70 years with endometrial and ovarian carcinoma without an increase in morbidity and mortality. Advanced chronologic age alone should not be considered a contraindication to full surgical treatment in these patients. Cancer 2001;92:2562–8. © 2001 American Cancer Society.

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“…Peritumoral or subserosal myometrial injection may enable detection of isolated para-aortic node involvement, without pelvic node involvement, which occurs in 1% to 3% of patients with endometrial cancer [31,32]. Detection of isolated para-aortic node involvement would improve outcome prediction and may decrease the complication rate in patients treated by postoperative whole-pelvis radiation therapy by limiting the use of extended surgical staging [33]. Nevertheless further studies are needed to address area of concern such as the apparently low SLN detection rate (61% to 82%) [3,20,23], the high false-negative rate (up to 50% in the study by Burke et al [3]), the poor results of sub-serosal injections [34], and the possible risk of cancer cell dissemination.…”

Section: Discussionmentioning

confidence: 97%