Transactions of the Sixty-Seventh Annual Meeting of the Central Association Of Obstetricians and GynecologistsLow-risk corpus cancer: Is lymphadenectomy or radiotherapy necessary?☆,☆☆
Section snippets
Patients and methods
From 1984 to 1993 a total of 815 patients with endometrial cancer underwent surgical treatment of the disease at the Mayo Clinic, Rochester, Minnesota, and their records were retrieved from the Mayo Clinic's database. We selected 612 patients with epithelial endometrial cancer who satisfied the following inclusion criteria: (1) they were treated with hysterectomy and removal of existing adnexal structures, and (2) no other malignancy was diagnosed within 5 years before or after the diagnosis of
Results
Among the 328 patients who entered the study the mean age was 62.8 ± 10.6 years (range, 22-87 years). The mean body mass index was 30.8 ± 8.6 (range, 17.8-65.5).
The surgical and pathologic demographic characteristics are shown in Table I. Characteristic No. %* Stage IA 57 17 IB 239 73 IIIA 23 7 IIIC 9 3 FIGO grade 1 223 68 2 105 32 Lymph-vascular
Comment
In accord with other authors,4, 5, 6 we described as at low risk for lymph node metastasis and recurrence those patients with endometrioid histologic subtype, myometrial invasion ≤50%, and histologic grade 1 or 2 disease. In fact myometrial invasion and tumor grade are well-recognized prognostic factors in endometrial cancer and are predictors of extrauterine spread.9, 12 Moreover, patients with endometrioid tumors have a better prognosis than do those with the other subtypes.
It is generally
Acknowledgements
Dr Mariani thanks Elio Tucci, MD, for his support and encouragement of her studies on endometrial cancer.
References (40)
- et al.
Relationship between surgical-pathological risk factors and outcome in clinical stage I and II carcinoma of the endometrium: a Gynecologic Oncology Group study
Gynecol Oncol
(1991) - et al.
Good outcome associated with a standardized treatment protocol using selective postoperative radiation in patients with clinical stage I adenocarcinoma of the endometrium
Gynecol Oncol
(1995) - et al.
Predicting pelvic lymph node metastasis in endometrial carcinoma
Gynecol Oncol
(1999) - et al.
Accuracy of frozen section diagnosis in surgical pathology: review of a 1-year experience with 24,880 cases at Mayo Clinic Rochester
Mayo Clin Proc
(1995) - et al.
EORTC Late Effects Working Group. Late effects toxicity scoring: the SOMA scale
Radiother Oncol
(1995) - et al.
Perioperative morbidity and mortality of high-dose-rate gynecologic brachytherapy
Int J Radiat Oncol Biol Phys
(1998) - et al.
Is lymphadenectomy useful in the treatment of endometrial carcinoma?
Gynecol Oncol
(1990) - et al.
Excellent long-term survival and absence of vaginal recurrences in 332 patients with low-risk stage I endometrial adenocarcinoma treated with hysterectomy and vaginal brachytherapy without formal staging lymph node sampling: report of a prospective trial
Int J Radiat Oncol Biol Phys
(1997) - et al.
Prognostic significance of gross myometrial invasion with endometrial cancer
Obstet Gynecol
(1996) - et al.
Accuracy of frozen-section diagnosis at surgery in clinical stage I and II endometrial carcinoma
Am J Obstet Gynecol
(1992)
Adjuvant vaginal high-dose-rate afterloading alone in endometrial carcinoma: patterns of relapse and side effects following low-dose therapy
Gynecol Oncol
Postoperative vaginal irradiation with high dose rate afterloading technique in endometrial carcinoma stage I
Int J Radiat Oncol Biol Phys
Low-risk endometrial carcinoma: assessment of a treatment policy based on tumor ploidy and identification of additional prognostic indicators
Gynecol Oncol
Surgery without radiotherapy for primary treatment of endometrial cancer
Obstet Gynecol
Should selective paraaortic lymphadenectomy be part of surgical staging for endometrial cancer?
Gynecol Oncol
Deoxyribonucleic acid analysis facilitates the pretreatment identification of high-risk endometrial cancer patients
Am J Obstet Gynecol
The relationship of local and distant failure from endometrial cancer: defining a clinical paradigm
Gynecol Oncol
Adenocarcinoma of the endometrium: survival comparisons of patients with and without pelvic node sampling
Gynecol Oncol
Cancer statistics, 2000
CA Cancer J Clin
The efficacy of postoperative vaginal irradiation in preventing vaginal recurrence in endometrial cancer
Int J Gynecol Cancer
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Supported by the Mayo Cancer Center (P30CA15083) and the Rochester Research Committee, Mayo Foundation, Rochester, Minnesota.
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Reprint requests: Karl C. Podratz, MD, PhD, Mayo Clinic, 200 First Street SW, Rochester, MN 55905.