Surgical pathologic staging in apparent stage I endometrial carcinoma

1993 ◽  
Vol 3 (6) ◽  
pp. 373-384 ◽  
Author(s):  
C. Mangioni ◽  
G. De Palo ◽  
E. Marubini ◽  
M. Del Vecchio
Keyword(s):  
Endometrial Carcinoma ◽  
Myometrial Invasion ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Multicenter Trial ◽  
Stage I ◽  
Surgical Staging ◽  
Poor Differentiation ◽  
Stage Ia ◽  
Deep Myometrial Invasion

A multicenter trial on apparent stage I endometrial carcinoma was performed to establish an intensive surgical staging, to formulate a treatment on the basis of the pathological extent of the disease and to determine the effectiveness of adjuvant medroxyprogesterone acetate therapy. The results of the first objective on 1,055 patients are herein reported. All patients had total abdominal hysterectomy, bilateral salpingo-oophorectomy, colpectomy of the superior third, and biopsy of lymph nodes positive or doubtful at radiological imaging or on surgical inspection. On the basis of the pathologic extent of the disease, patients were classified into five categories: disease outside the uterine corpus (RE); disease limited to endometrium (RO); disease with inner myometrial invasion and high or moderate grade (R1); disease with deep myometrial invasion or poor differentiation (R2); disease with positive retroperitoneal nodes (R3). One hundred and forty-six patients were RE, 163 RO, 382 R1, 341 R2 and 23 R3. The results showed a clinical understaging in 16% of the cases. According to the new FIGO classification, the relapse-free survival at 84 months was 96% for patients at stage IA, 92% for patients with stage IB-C, 86% for stage IIA-B, 76% for stage IIIA-B and 74% for patients at stage IIIC. These data confirm the importance of an intensive surgical staging in apparent stage I endometrial carcinoma.

Endometrial Stage I Carcinoma Treated with Surgery and Adjuvant Irradiation: A Retrospective Analysis

1995 ◽  
Vol 81 (4) ◽  
pp. 256-260 ◽  
Author(s):  
Giovanni Boz ◽  
Antonino De Paoli ◽  
Roberto Innocente ◽  
Lino Del Pup ◽  
Renato Talamini ◽  
...  
Keyword(s):  
Endometrial Carcinoma ◽  
Local Control ◽  
Combined Treatment ◽  
Distant Metastases ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Stage I ◽  
Lymph Node Sampling ◽  
Adjuvant Irradiation ◽  
Postoperative Irradiation

Aims and background Data from the literature show that the incidence of pelvic recurrences in poor prognosis endometrial carcinoma is significantly reduced by combined surgery and radiotherapy compared to surgery alone. Methods In this paper we analyze the results of the combined treatment surgery and adjuvant irradiation in patients with endometrial carcinoma with regard to survival, site of progression, and toxicity. The surgical treatment consisted of total abdominal hysterectomy and bilateral salpingo-oophorectomy in 40 patients. Pelvic and para-aortic node dissection was performed in 19 patients and lymph node sampling in 5. Results Overall 5-year survival was 85%. One patient had local failure, and 5 patients with local control of disease had distant metastases. Toxicity was mild and transient. Conclusions Our experience confirms the data of the literature. Postoperative irradiation is a safe and well-tolerated treatment that can achieve a good local control in high risk, stage I, endometrial carcinoma. The control of distant metastases remains an open question.

scholarly journals The Uterine Adenosarcoma in a Young Woman Treated by TAH/BOS and Combined Adjuvant Therapy: A Case Report

2020 ◽  
Author(s):  
Soodabeh Shahidsales ◽  
Marjaneh Farazestanian ◽  
Noorieh Sharifi‐Sistani ◽  
Sara Rasta ◽  
Seyed Alireza Javadinia
Keyword(s):  
Adjuvant Therapy ◽  
Myometrial Invasion ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Advanced Stage ◽  
Deep Myometrial Invasion ◽  
One Year ◽  
Disease Free

We aimed to report a woman suffering from uterine adenosarcoma in the perimenopause period. The patient had undergone total abdominal hysterectomy (TAH) with bilateral salpingo-oophorectomy (BSO) and also received adjuvant chemotherapy and radiotherapy. Moreover, she was reported as disease-free with no evidence of recurrence or metastasis despite the existence of numerous risk factors such as deep myometrial invasion as well as sarcomatous overgrowth after one year of follow-up. The results obtained about this patient could highlight the role of adjuvant therapy in terms of managing treatments for patients suffering from MASO, especially in the presence of deep myometrial invasion and an advanced stage.

Is Complete Surgical Staging Necessary in Clinically Early-Stage Endometrial Carcinoma?

2009 ◽  
Vol 19 (6) ◽  
pp. 1057-1061 ◽  
Author(s):  
Nakarin Sirisabya ◽  
Tarinee Manchana ◽  
Pongkasem Worasethsin ◽  
Nipon Khemapech ◽  
Ruangsak Lertkhachonsuk ◽  
...  
Keyword(s):  
Endometrial Carcinoma ◽  
Early Stage ◽  
Clinical Stage ◽  
Myometrial Invasion ◽  
Low Risk ◽  
Histologic Grade ◽  
Surgical Staging ◽  
Pelvic Node ◽  
Node Metastasis ◽  
Deep Myometrial Invasion

The purpose of this study was to evaluate the incidence of pelvic/para-aortic node metastases and the other pathological characteristics from medical records of patients with endometrial carcinoma treated at King Chulalongkorn Memorial Hospital, Bangkok, Thailand, between1996 and 2005. The records of 213 patients with endometrial carcinoma who had complete surgical staging were reviewed. A particular focus was on clinically early-stage disease. Clinical staging could be determined in 206 patients. Of the 206 patients, 182 (88.3%) presented with clinical stage I disease. However, only 142 (78%) of these patients were confirmed as surgical stage I and 22% were upstaged. Preoperative histologic grade was diagnosed inaccurately in 15.9% of patients and 7.7% were upgraded. Of patients with preoperative histologic grade 1, 33% had deep myometrial invasion, 8.2% had pelvic node metastasis, and 3.3% had para-aortic node metastasis. Even in clinical stage IaG1, pelvic node metastasis occurred in 5.6% and para-aortic node metastasis in 1.3%. It has been suggested that complete surgical staging may not be necessary in patients with low-risk endometrial carcinoma who have disease limited to the uterus without grade 3 or deep myometrial invasion. However, proper selection of such low-risk patients remains problematic. In situations where there is limited preoperative and intraoperative assessment of high-risk factors, particularly radiographic imaging and frozen section assessment, the role of complete surgical staging is beneficial.

Intraoperative frozen section examination of myometrial invasion depth in patients with endometrial carcinoma

1994 ◽  
Vol 4 (5) ◽  
pp. 352-355 ◽  
Author(s):  
J. Atad ◽  
Y. Ben-David ◽  
M. Hallak ◽  
O. Klein ◽  
H. Abramovici ◽  
...  
Keyword(s):  
Endometrial Carcinoma ◽  
Frozen Section ◽  
Myometrial Invasion ◽  
Accurate Method ◽  
Figo Stage ◽  
Stage I ◽  
Frozen Sections ◽  
Invasion Depth ◽  
Surgical Specimen ◽  
Deep Myometrial Invasion

The objective of this study was to evaluate the accuracy of frozen sections (FS) as a method for estimation of the depth of myometrial invasion in patients with stage I endometrial carcinoma. During a 3-year period (1989–1992), 46 consecutive patients with FIGO stage I endometrial carcinoma were included in this study. The depth of myometrial invasion was estimated by FS examination performed during surgery. The final histologic findings of the surgical specimen were compared to the FS evaluation. The results of this study demonstrate that deep or superficial myometrial invasions were correctly diagnosed by FS in 42 out of 46 cases (91.3%). Three cases (6.6%) with deep myometrial invasion were falsely diagnosed as superficially invasive. One case with superficial invasion (2.1%) was falsely diagnosed as deeply invasive. In conclusion, intraoperative FS examination of depth of myometrial invasion by endometrial carcinoma is a simple and accurate method, providing a good correlation with the final histologic report of the surgical specimen.

Postoperative Radiotherapy and Surgery in Stage I Endometrial Carcinoma: A 10-Year Experience

1998 ◽  
Vol 84 (1) ◽  
pp. 52-56 ◽  
Author(s):  
Giovanni Boz ◽  
Antonino De Paoli ◽  
Roberto Innocente ◽  
Renato Talamini ◽  
Carlo Scarabelli ◽  
...  
Keyword(s):  
Endometrial Carcinoma ◽  
Local Control ◽  
Postoperative Radiotherapy ◽  
Combined Treatment ◽  
Distant Metastases ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Stage I ◽  
Good Local Control ◽  
Postoperative Irradiation

Background Data from the literature show that the incidence of pelvic recurrences in poor prognosis endometrial carcinoma is significantly reduced by combined surgery and radiotherapy compared to surgery alone. Methods In this paper we analyze the results of the combined treatment surgery plus adjuvant irradiation in patients with endometrial carcinoma with regard to survival, site of progression, and toxicity. The surgical treatment consisted of total abdominal hysterectomy and bilateral salpingo-oophorectomy. Pelvic and para-aortic node dissection was performed. Results The overall 5-year survival was 88%. Three patients had local failure. Ten patients with local control of disease had distant metastases and 2 had local and distant recurrences. Conclusions Our experience confirms the data of the literature. Postoperative irradiation is a safe and well tolerated treatment which can achieve good local control in high-risk stage I endometrial carcinoma. The control of distant metastases remains an open issue.

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