RT Journal Article
SR Electronic
T1 Distribution and Volume of Extrauterine Disease in Uterine Serous Carcinoma: Is Minimally Invasive Surgery a Suitable Approach?
JF International Journal of Gynecologic Cancer
JO Int J Gynecol Cancer
FD BMJ Publishing Group Ltd
SP 87
OP 91
DO 10.1097/IGC.0000000000000326
VO 25
IS 1
A1 Tina A. Ayeni
A1 Mariam M. AlHilli
A1 Jamie N. Bakkum-Gamez
A1 Andrea Mariani
A1 Michaela E. McGree
A1 Amy L. Weaver
A1 William A. Cliby
A1 Gary L. Keeney
A1 Karl C. Podratz
A1 Sean C. Dowdy
YR 2015
UL http://ijgc.bmj.com/content/25/1/87.abstract
AB Objective Minimally invasive surgery (MIS) is the preferred technique for managing endometrial cancer. Given that uterine serous carcinoma (USC) has a predilection for multiquadrant peritoneal dissemination, our objective was to estimate the potential risk for overlooking occult peritoneal spread with the use of MIS.Methods A single-institution, retrospective review was conducted of patients who underwent primary surgical staging for endometrial cancer via laparotomy between 1999 and 2008. Patterns of metastases were analyzed to estimate the potential risk for understaging via MIS.Results A total of 202 USC cases met inclusion criteria. Pelvic and para-aortic nodes were positive in 59 (36%) of 166 and 43 (31%) of 138, respectively. Stage IVb disease was diagnosed in 77 (38%) of 202 patients. The majority (86%, 66/77) harbored bulky and/or multisite macroscopic abdominal implants. Isolated microscopic peritoneal disease was present in 5 of 77 cases (6% of stage IV, 2% of the entire cohort) but, in all cases, was limited to the omentum; 6 of 77 cases (8% of stage IV, 3% of the cohort) harbored a single implant in the context of a negative omentum but, in all cases, were macroscopic (locations included the ileum, the diaphragm, and the base of the mesentery).Conclusions For providers who aim to remove all visible disease in patients with USC, the rate of extrauterine disease escaping detection using MIS is low (<3%) provided an omentectomy is performed together with staging.