Inability of Preoperative Computed Tomography Scans to Accurately Predict the Extent of Myometrial Invasion and Extracorporal Spread in Endometrial Cancer

Zerbe, Marc J.; Bristow, Robert E.; Grumbine, Francis C.; Montz, F.J.

doi:10.1006/gyno.2000.5820

Cited by 59 publications

(21 citation statements)

References 9 publications

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“…The ovarian metastases are microscopic in 18-70% of the cases (1, 6). Thus, preoperative imaging studies (7) or macroscopic intraoperative appearance cannot be relied on to exclude their presence.…”

Section: Discussionmentioning

confidence: 98%

Ovarian metastasis in women with clinical stage I endometrial carcinoma

Gemer

Bergman

Segal

2004

Acta Obstet Gynecol Scand

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The risk of ovarian metastasis in women with well to moderately differentiated endometrial cancer, myometrial invasion limited to less than one half of the myometrium, negative peritoneal cytology and no evidence of metastatic lymph node spread is negligible. Young patients with a preoperative histological diagnosis of well to moderately differentiated endometrial carcinoma may be surgically staged, leaving the final decision regarding removal of the ovaries pending a thorough pathological review of the surgical specimens.

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Section: Discussionmentioning

confidence: 98%

Ovarian metastasis in women with clinical stage I endometrial carcinoma

Gemer

Bergman

Segal

2004

Acta Obstet Gynecol Scand

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“…The reported sensitivity of CT, MRI and FDG-PET (fluor- D -deoxyglucose positron emission tomography) is 57 [27], 50 [27] and 67% [28], respectively. To date, reports on patients with EC and lymph node metastasis treated conservatively are lacking.…”

Section: Controversial Topicsmentioning

confidence: 99%

Controversies of the Hormonal Conservative Treatment of Endometrial Cancer

Minig

Franchi

Bernabe

et al. 2013

Gynecol Obstet Invest

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Background: Hysterectomy plus salpingo-oophorectomy represents the standard treatment for patients with well-differentiated endometrial cancer (EC) limited to the endometrium. It is estimated that over 5% of EC are diagnosed in nulliparous women aged 35-44 years. In addition, EC can affect obese women with diabetes, hypertension and other comorbidities increasing the surgical risk. Methods: This article reviews the English literature in PubMed regarding hormonal treatment of EC. Results: Use of hormonal therapies has resulted in complete remission in 60-70%; many of these women were able to achieve full-term pregnancies, and in case of contraindication to surgery, resection could be avoided. Several topics, however, such as patient selection, interobserver histologic evaluation, the type/duration of hormonal treatment, modality of evaluation before treatment and surveillance after treatment, which are still subject to controversy, are therefore discussed in this paper. Conclusion: Uterus-sparing treatment of well-differentiated EC limited to the endometrium is feasible and has acceptable efficacy in women with increased surgical risk or those who wish to preserve their fertility. Although the methods applied to determine disease extent beyond the endometrium are still unsatisfactory, patient selection is a crucial factor determining the outcome of treatment. However, women must be fully informed about the possibility of treatment failure and the necessity of a close follow-up after therapy.

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“…Few studies have evaluated the accuracy of CT scan for the evaluation of the locoregional extension of EC. Accuracy of CT scan for assessment of the outer half of the myometrium ranges between 62 and 87% and very uneven sensibility and specificity reported (10-83% and 42-100% respectively) [42][43][44] . Concerning cervical stromal invasion, performances of CT scan is insufficient, with low sensibility and PPV (20-25% et 9-14% respectively) 36,38 .…”

Section: Predicitng Lymph Node Metastasismentioning

confidence: 99%

Staging for endometrial cancer: The controversy around lymphadenectomy – Can this be resolved?

Koskas¹,

Rouzier²,

Amant³

2015

Best Practice & Research Clinical Obstetrics & Gynaecol

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Endometrial cancer remains the most common malignancy of the female genital tract. Lymph node metastasis is one of the most important prognostic factors and stratification into pelvic lymph node invasion (stage IIIC1) and para-aortic lymph node invasion (stage IIIC2) improved the predictive value of the 2009 FIGO classification.Radiological examination such as magnetic resonance imaging and positron emission tomography-computed tomography do not have good enough sensitivity to avoid lymphadenectomy for the assessment of lymph node invasion. Prediction scores are becoming more and more valuable to exclude lymph node metastasis in low risk groups and biomarkers could help to identify patients with high risk lymph node metastatic probability.The therapeutic role of lymph node dissection remains debated. Several endpoints can be considered to evaluate the opportunity of lymphadenectomy in endometrial cancer.Firstly, we compare survival according to the realization, the extent and the numbers of nodes removed during lymphadenectomy. Secondly, we assess the opportunity of lymphadenectomy in order to tailor adjuvant treatment modalities. Thirdly, we analyze the surgical complication rate after pelvic lymphadenectomy.

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Inability of Preoperative Computed Tomography Scans to Accurately Predict the Extent of Myometrial Invasion and Extracorporal Spread in Endometrial Cancer

Cited by 59 publications

References 9 publications

Ovarian metastasis in women with clinical stage I endometrial carcinoma

Ovarian metastasis in women with clinical stage I endometrial carcinoma

Controversies of the Hormonal Conservative Treatment of Endometrial Cancer

Staging for endometrial cancer: The controversy around lymphadenectomy – Can this be resolved?

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