Systematic lymphadenectomy influences adjuvant therapy in presumed localized endometrioid endometrial cancer, meeting Mayo criteria

2018 ◽  
Vol 149 ◽  
pp. 93-94
Author(s):  
A.B. Pendlebury ◽  
M. Radeva ◽  
P.G. Rose
2015 ◽  
Vol 25 (8) ◽  
pp. 1437-1444 ◽  
Author(s):  
Nicole D. Fleming ◽  
Pamela T. Soliman ◽  
Shannon N. Westin ◽  
Ricardo dos Reis ◽  
Mark Munsell ◽  
...  

2013 ◽  
Vol 130 (1) ◽  
pp. e72-e73
Author(s):  
S. Owusu-Darko ◽  
J. Rauh-Hain ◽  
L. Bradford ◽  
M. Worley ◽  
N. Horowitz ◽  
...  

2017 ◽  
Vol 27 (9) ◽  
pp. 1888-1894 ◽  
Author(s):  
Jung-Yun Lee ◽  
Jae Weon Kim ◽  
Taek Sang Lee ◽  
Rongyu Zang ◽  
Xiaojun Chen ◽  
...  

ObjectiveThe aim of this article was to identify current practice patterns of care in the surgical and adjuvant management of endometrial cancer in East Asia (Korea, Japan, China, and Taiwan)MethodsA validated 20-item questionnaire on surgical and adjuvant procedures for endometrial cancer was sent to active members of the Gynecologic Oncology Group from 4 East Asian countries. Data were collected using an Internet survey database.ResultsA total of 376 members from Korea (n = 108), Japan (n = 140), China (n = 51), and Taiwan (n = 77) responded to the survey. With respect to early-stage endometrial cancer, laparotomy (57.7%) was the most preferred mode of surgery in Japan, whereas laparoscopy was the most common in the remaining 3 countries. For patients with presumed stage IA/G1 disease, approximately 65% of respondents favored systematic lymphadenectomy. For patients with presumed stage IB disease, most respondents stated that systematic lymphadenectomy should be performed (92.6% for stage IBG1, 95.8% for stage IBG3). Meanwhile, the extents of lymphadenectomy differed among countries (P < 0.001). Considerable agreement was noted between countries regarding indications for adjuvant therapy for stage IIIA or IIIC1 disease, whereas the preferred options for adjuvant therapy varied according to country (P < 0.001). Specifically, chemotherapy was the most common selection option in Japan, whereas concurrent chemoradiotherapy was preferred in the other countries.ConclusionsConsiderable agreement was identified with respect to the necessity for lymphadenectomy for surgical staging and the indications for adjuvant therapy. However, extents of surgery and preferred adjuvant treatment options for endometrial cancer varied widely between countries.


2018 ◽  
Vol 28 (1) ◽  
pp. 107-113 ◽  
Author(s):  
Vivek Nama ◽  
Amit Patel ◽  
Lisa Kirk ◽  
John Murdoch ◽  
Joanne Bailey

ObjectiveThe long-standing protocol at our center for apparent stage I and II endometrial cancers comprises hysterectomy and bilateral salpingo-oophorectomy without lymphadenectomy. Adjuvant treatment is based in line with Postoperative Radiation Therapy in Endometrial Carcinoma 1 protocol. Our aim was to quantify the number of patients who would avoid external beam radiation therapy (EBRT) in our institution if we adopted a protocol of lymphadenectomy to tailor adjuvant EBRT and its impact on cost and quality of life.DesignRetrospective case-cohort study.SettingGynecological oncology center.MethodsAll endometrial cancers treated from 2007 to 2012 were included. The European Organization for Research and Treatment of Cancer (EORTC) quality of life (QLQ-30) and endometrial cancer specific (EN-24) questionnaires were used to measure the quality of life. The NHS tariff for EBRT, VBT and lymphadenectomy were obtained from our Trust’s contract with the local commissioning groups.Main Outcome MeasuresQuality of life and cost.ResultsSystematic pelvic lymphadenectomy in early endometrial cancers of all grades would avoid EBRT in 23.3% of patients, and if performed for grade 2 and 3 cancers, 39.5% of patients would avoid EBRT. The global health scores were significantly lower, and pain scores were considerably higher in patients who received EBRT. Performing systematic lymphadenectomy and tailored adjuvant therapy in grade 2 and 3 endometrial cancers would save £134,691 and for all grades save £37,161 for every 100 patients treated with early endometrial cancer.ConclusionSystematic lymphadenectomy with tailored adjuvant therapy may offer better QoL with reduced cost to NHS without a reduction in overall survival.


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