scholarly journals 54 A prospective randomised study of open versus robotic assisted para aortic lymph node dissection in high risk endometrial carcinoma – a novel technique

2019 ◽  
Author(s):  
VK Ahuja ◽  
S Somashekhar ◽  
K Ashwin ◽  
C Rohit Kumar ◽  
Y Ramya
2011 ◽  
Vol 07 (03) ◽  
pp. 188
Author(s):  
Giovanni Di Vagno ◽  

Is para-aortic lymph node dissection beneficial in the treatment of endometrial cancer? Para-aortic lymph node dissection is associated with a survival benefit in women with intermediate or high-risk endometrial cancer: a retrospective cohort study of women with endometrial cancer reported that eight-year, disease-specific survival rates were significantly higher for women with intermediate or high-risk disease who underwent combined pelvic and para-aortic lymph node dissection compared with pelvic lymph node dissection alone; there was, however, no significant difference in women with low-risk disease. What is the best, cutting-edge management for clear cell and papillary serous cancers of the endometrium? There is increasing evidence of the efficacy of an integrated and modified approach for these special histotypes compared with standard treatment for endometrial cancer: platinum/taxane-based chemotherapy is effective in determining relapse/survival benefits of both early- and advanced-stage patients. Is it possible to predict optimal cytoreduction in ovarian cancer? A high preoperative serum CA-125 level is associated with a lower likelihood of optimal cytoreduction: a meta-analysis of 14 studies found that serum CA-125 ≥500 U/ml has sensitivity and specificity for optimal cytoreduction of 69 and 63 %, respectively. Can multiple conisation procedures increase the risk of preterm delivery? The risk of preterm delivery increases in women with cervical intraepithelial neoplasia who undergo more than one cervical conisation. A population-based retrospective study reported that, compared with women who have undergone one prior conisation, the risk of preterm delivery increases threefold in women with two prior conisations. How often do the human papillomavirus (HPV) genotypes 16 and 18 cause invasive cervical cancer? In recent decades, the rate at which the major HPV genotypes (contained within HPV vaccines) caused invasive cervical cancers remained stable. This observation is crucial, given the large amount of public money invested in prophylactic HPV vaccine campaigns.


2015 ◽  
Vol 193 (4S) ◽  
Author(s):  
Kimberly Fischer ◽  
Michael Santomauro ◽  
Eric Biewenga ◽  
Justin Nork ◽  
Patrick Scarborough ◽  
...  

2014 ◽  
Vol 24 (1) ◽  
pp. 91-96 ◽  
Author(s):  
Madeleine Courtney-Brooks ◽  
Jennifer M. Scalici ◽  
A. Rauda Tellawi ◽  
Leigh A. Cantrell ◽  
Linda R. Duska

ObjectiveLiterature suggests that para-aortic lymphadenectomy (para-aortic lymph node dissection [PALND]) has a therapeutic benefit for women with intermediate- to high-risk endometrial adenocarcinoma. We hypothesized that the observed survival advantage of PALND is a reflection of the general health of the patient rather than a therapeutic benefit of surgery.MethodsWomen with intermediate- to high-risk endometrial adenocarcinoma diagnosed from 2002 to 2009 at a single institution were identified. Medical comorbidities, pathology, and survival information were abstracted from the medical record. The χ2 test or the t test was used for univariate analysis. Overall survival (OS) and disease-specific survival (DSS) were calculated using the Kaplan-Meier method.ResultsA total of 253 women with a mean age of 64 years were identified. Of these women, 174 had a pelvic lymphadenectomy (pelvic lymph node dissection [PLND]) and 82 had PLND and PALND. The rate of positive nodes was 13% (23/174) for the women who had PLND and was 7% (6/82) for those who had PLND and PALND. Only 1.2% (1/82) of the women who had PLND and PALND had negative pelvic but positive para-aortic nodes. The patients who had PALND had a lower body mass index and were less likely to have significant medical comorbidities. The patients who had PALND had improved 5-year OS (96% vs 82%, P = 0.007) but no difference in 5-year DSS (96% vs 89%, P value = not significant).ConclusionsWomen with intermediate- to high-risk endometrial adenocarcinoma who undergo PALND have improved OS but no improvement in DSS. The lack of difference in DSS supports the hypothesis that underlying comorbidities as opposed to lack of PALND result in poorer outcome.


Sign in / Sign up

Export Citation Format

Share Document