Recurrence patterns in patients with stage IIIC1 versus IIIC2 endometrial adenocarcinoma.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e15501-e15501
Author(s):  
Catherine Bevan ◽  
Christa Irene Nagel ◽  
Todd Patrtick Boren ◽  
David Scott Miller ◽  
Siobhan Marie Kehoe ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Endometrial Adenocarcinoma ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Distant Recurrence ◽  
Exact Test ◽  
Frontline Treatment ◽  
Recurrence Patterns ◽  
The Mean ◽  
To Receive

e15501 Background: To identify differences in recurrence patterns between stage IIIC1 and IIIC2 endometrial adenocarcinomas. Methods: A retrospective review was performed with IRB approval of all patients treated for stage IIIC1 and IIIC2 endometrial adenocarcinoma at our institution from 1989-2011. Patients were required to have comprehensive surgical staging including total abdominal hysterectomy, bilateral salpingo-ophorectomy, pelvic and paraaortic lymph node dissection. Descriptive statistics were performed using Microsoft Excel 2011 and Fischer’s exact test, Kaplan-Meier analyses were used to compare disease free (DFS) and overall survival (OS). Results: Eighty-seven patients with stage IIIC endometrial adenocarcinoma were identified, of which 69 were evaluable. The mean age was 59 years and the mean follow up was 32 months. There were 31 patients with stage IIIC1 and 38 patients with stage IIIC2 disease. There was no statistical difference in histology between the two groups: 47 endometrioid, 11 papillary serous, and 11 with other types of adenocarcinoma. Patients with stage IIIC1 disease were more likely to receive pelvic radiation (p=0.0004) and patients with IIIC2 disease were more likely to receive chemotherapy (p=0.014). Median DFS was 28.9 months (range 0-112) and 15.0 months (range 0-166) (p=0.017) and median OS was 31.9 months (range 0-134) and 18.0 months (range 0-166) (p=0.061) for the IIIC1 and IIIC2 groups respectively. Seven of 31 (23%) patients with stage IIIC1 disease recurred: 1 (14%) at the vaginal cuff and 6 (86%) distant. The patient who recurred locally was initially treated with chemotherapy alone. Of the 6 patients with distant recurrences only 1 received chemotherapy. Twelve of the 38 (32%) patients with stage IIIC2 experienced a recurrence: 6 (50%) vaginal/pelvic and 6 (50%) distant. There was a difference between the rates of local versus distant recurrence in patients with IIIC1 and IIIC2 endometrial cancer. Conclusions: IIIC1 patients were less likely to receive systemic chemotherapy and more likely to recur distantly. Our findings suggest a role for adjuvant chemotherapy and radiation in the frontline treatment of both IIIC1 and IIIC2 endometrial cancer.

Xenon Provides Faster Emergence from Anesthesia than Does Nitrous Oxide-sevoflurane or Nitrous Oxide-isoflurane 

1997 ◽  
Vol 86 (6) ◽  
pp. 1273-1278 ◽  
Author(s):  
Takahisa Goto ◽  
Hayato Saito ◽  
Masahiro Shinkai ◽  
Yoshinori Nakata ◽  
Fumito Ichinose ◽  
...  
Keyword(s):  
Nitrous Oxide ◽  
Minimum Alveolar Concentration ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Patient Demographics ◽  
The Mean ◽  
American Society ◽  
End Tidal ◽  
To Receive ◽  
Rapid Emergence

Background Xenon, an inert gas with anesthetic properties (minimum alveolar concentration [MAC] = 71%), has an extremely low blood:gas partition coefficient (0.14). Therefore, we predicted that xenon would provide more rapid emergence from anesthesia than does N2O+isoflurane or N2O+sevoflurane of equivalent MAC. Methods Thirty American Society of Anesthsiologists class I or II patients undergoing total abdominal hysterectomy were randomly assigned to receive 60% xenon, 60% N2O + 0.5% isoflurane, or 60% N2O + 0.70% sevoflurane (all concentrations are end-tidal: n = 10 per group). After placement of an epidural catheter, anesthesia was induced with standardized doses of midazolam, thiopental, and fentanyl. Thirty minutes later, xenon, N2O+isoflurane, or N2O+sevoflurane was started as previously assigned. These regimens were supplemented with epidural anesthesia with mepivacaine so that the mean arterial pressure and heart rate were controlled within 20% of the preoperative values. At the end of operation lasting approximately 2 h, all inhalational anesthetics were discontinued, and the patients were allowed to awaken while breathing spontaneously on an 8 l/min inflow of oxygen. A blinded investigator recorded the time until the patient opened her eyes on command (T1), was judged ready for extubation (T2), could correctly state her name, her date of birth, and the name of the hospital (T3), and could count backward from 10 to 1 in less than 15 s (T4). Results Emergence times from xenon anesthesia were: T1, 3.4 +/- 0.9 min; T2, 3.6 +/- 1 min; T3, 5.2 +/- 1.4 min; and T4, 6.0 +/- 1.6 min (mean +/- SD). These were one half to one third of those from N2O+sevoflurane (T1, 6.0 +/- 1.7 min; T4, 10.5 +/- 2.5 min) or N2O+isoflurane (T1, 7.0 +/- 1.9 min; T4, 14.3 +/- 2.8 min) anesthesia. The three groups did not differ in terms of patient demographics, the duration of anesthesia, the amount of epidural mepivacaine administered, or the postoperative pain rating. No patient could recalls intraoperative events. Conclusions Emergence from xenon anesthesia is two or three times faster than that from equal-MAC N2O+isoflurane or N2O+sevoflurane anesthesia.

scholarly journals Evaluation of clinical outcome of laparoscopic hysterectomy versus open abdominal hysterectomy with pelvic lymphadenectomy in endometrial carcinoma early stage

2021 ◽  
Vol 10 (6) ◽  
pp. 2203
Author(s):  
Waleed M. Tawfik ◽  
Wagdy M. Amer ◽  
Ahmed F. Sherif
Keyword(s):  
Endometrial Cancer ◽  
Blood Loss ◽  
Hospital Stay ◽  
Early Stage ◽  
Clinical Stage ◽  
Laparoscopic Hysterectomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Pelvic Lymphadenectomy ◽  
The Mean

Background: the aim of this study was to compare the operative, post-operative, and the oncological short-term outcomes of laparoscopic hysterectomy with lymphadenectomy and open abdominal hysterectomy with lymphadenectomy for early-stage endometrial cancer.Methods: 80 patients with clinical stage I endometrial cancer were enrolled in this trial; they were divided according to their selection of the method of intervention after counselling into two groups: total laparoscopic hysterectomy with pelvic lymphadenectomy group and total abdominal hysterectomy with pelvic lymphadenectomy group.Results: The mean operative time in the TLH group was 140.85± 10.033 minutes and was 118.45±12.713 minutes in the TAH group (p<0.001). The mean blood loss in the TLH group was 127.5±42.9 ml and 220.5± 84.82 ml in TAH group (p<0.001). The mean duration of postoperative ileus was 12.8±5.022 hours in the TLH group, and it was 22.3±5.573 hours in the TAH group (p<0.001). The mean time of hospital stay in the TLH group was 26.7±5.667 hours and in the TAH group was 116.4± 17.31 hours (p<0.001).Conclusions: Complete surgical staging of endometrial cancer can be performed using laparoscopy as an alternative to routine open method with similar efficacy about nodal retrieval and complication rate, and better operative and postoperative compliance in means of blood loss, ileus and hospital stay which may have an implication on cost saving in the medical service. Lymphadenectomy can be omitted in low-risk cases of endometrial cancer.

scholarly journals CLINICAL PROFILE AND MANAGEMENT OPTION OF FIBROID UTERUS PATIENTS OF OBSTETRICS AND GYNAECOLOGY DEPARTMENT OF DMCH, LAHERIASARAI, BIHAR

2020 ◽  
pp. 1-2
Author(s):  
Sangeeta Singh ◽  
Renu Jha ◽  
Seema Seema ◽  
Debarshi Jana
Keyword(s):  
Uterine Fibroids ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Management Options ◽  
Fibroid Uterus ◽  
Number Of Patients ◽  
Study Results ◽  
The Mean ◽  
Benign Tumours ◽  
Symptomatic Uterine Fibroid

Background: Fibroids are the most common benign tumours of smooth muscle cells of uterus in females and typically found during the middle and later reproductive years. As fibroid is an estrogen and progesterone dependent tumour, it gradually decreases in size during starting of menopause. The objective of this presented study was to determine management options among fibroid uterus patients. Methods: 50 number of patients were included in this study those who’s age of 20-55, with symptomatic uterine fibroid and undergone hysterectomy or myomectomy. Postmenopausal, Pregnancy and Asymptomatic fibroid were excluded from this study. Results: The study showed that 52 percent of patient having fibroid uterus were belonged to 31-40 years of age. The mean age was 41.2±6.07. The majority 74% of patients in this study presented with menstrual abnormalities, 40% presented with abdominal lump. Dysmenorrhoea was 26%, 6% patient had primary subfertility and 14% secondary subfertility. Total Abdominal Hysterectomy (TAH) with unilateral salpingo- oophorectomy done in 10% cases, TAH with bilateral salpino-oophorectomy in 22% cases, non descent vaginal hysterectomy in 6% cases, myomectomy done in 20% cases and polypectomy was done in 2% cases. Conclusion: Uterine fibroids are very common in women and frequently in late reproductive and perimenopausal years. It is also a common gynecological problem in our country, which frequently disturbs the lives of woman. Women now have choice of therapies for the treatment of fibroids.

Long-term quality of life outcomes of women treated for early-stage endometrial cancer

2020 ◽  
pp. ijgc-2020-002145
Author(s):  
Saira Sanjida ◽  
Andreas Obermair ◽  
Val Gebski ◽  
Nigel Armfield ◽  
Monika Janda
Keyword(s):  
Quality Of Life ◽  
Endometrial Cancer ◽  
Early Stage ◽  
Age Groups ◽  
Laparoscopic Hysterectomy ◽  
Well Being ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy

ObjectiveTo compare long-term quality of life in women treated for early-stage endometrial cancer with population norms, and to compare quality of life outcomes of patients who had total laparoscopic or total abdominal hysterectomy.MethodsOnce the last enrolled patient had completed 4.5 years of follow-up after surgery, participants in the Laparoscopic Approach to Cancer of the Endometrium (LACE) clinical trial were asked to complete a self-administered questionnaire. Two instruments—EuroQol 5 Dimension 3-level (EQ-5D-3L) and the Functional Assessment of Cancer Treatment-General Population (FACT-GP)—were used to determine quality of life. The mean computed EQ-5D-3L index scores for LACE participants at different age categories were compared with Australian normative scores; and the FACT-GP scores were compared between patients treated with surgical treatments.ResultsOf 760 women originally enrolled in the LACE trial, 259 (50.2%) of 516 women consented to provide long-term follow-up data at a median of 9 years (range 6—12) after surgery. On the EQ-5D-3L, long-term endometrial cancer survivors reported higher prevalence of anxiety/depression than normative levels across all age groups (55–64 years, 30% vs 14.9%; 65–74 years, 30.1% vs 15.8%; ≥75 years, 25.9% vs 10.7%). For women ≥75 years of age, the prevalence of impairment in mobility (57.6% vs 43.3%) and usual activities (58.8% vs 37.9%) was also higher than for population norms. For the FACT-GP, the physical (effect size: −0.28, p<0.028) and functional (effect size: −0.30, p<0.015) well-being sub-scale favored the total laparoscopic hysterectomy compared with total abdominal hysterectomy recipients.ConclusionCompared with population-based norms, long-term endometrial cancer survivors reported higher prevalence of anxiety/depression across all age groups, and deficits in mobility and usual activities for women aged ≥75 years. Physical and functional well-being were better among women who were treated with total laparoscopic hysterectomy than among those receiving total abdominal hysterectomy.

scholarly journals Uterine Myoma: A Profile of Nepalese women

1970 ◽  
Vol 1 (2) ◽  
pp. 47-50
Author(s):  
Pramila Pradhan ◽  
Nitish Acharya ◽  
Binit Kharel ◽  
Manoj Manjin
Keyword(s):  
Abdominal Mass ◽  
College Teaching ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Early Marriage ◽  
Early Completion ◽  
Medical College ◽  
Underlying Risk Factor ◽  
The Mean ◽  
Myoma Uteri

Objectives: To determine the most common age and parity for the development of myoma uteri. To find out any relation between age of the last child and the development of myoma uteri. To determine the treatment protocal and outcome of treatment. Materials/methods: This study was carried out at Nepal Medical College Teaching Hospital from Jan 2001 to 31st June 2006. All cases of myoma uteri admitted in Gynaecological ward was included.. Histological evidence of myoma confirmed the diagnosis. Age, parity and age of the last child, clinical features, surgical procedures and outcome of surgery were considered. Results: A total of 137 cases of myoma uteri was operated during five and half years period. This represented 38.5 %of all abdominal hysterectomy performed during the same period. The mean age was 43.3 years with median parity at 1-3 and the mean age of last child at 12years. Excessive menstrual bleeding 73.0%, abdominal mass and pain 58.4%, dysmenorrhea 18.2% and infertility 7.3% were the common symptoms. Total abdominal hysterectomy was the mainstay of treatment. Patients were happy with the treatment specially those with severe and multiple symptoms Postoperative complications were not significant. There was one death due to pulmonary embolism who had mesothelioma of pleura diagnosed by pleural biopsy before operation. Conclusion: Early marriage and early completion of the family is the social trend in Nepalese society. Myoma is common in 4th-5th decade of life in multi parity with the age of last child around 12years. This long standing secondary infertility may be an underlying risk factor in the development of myoma uteri.   doi:10.3126/njog.v1i2.2397 N. J. Obstet. Gynaecol Vol. 1, No. 2, p. 47-50 Nov-Dec 2006   

scholarly journals Endometrial Adenocarcinoma and Mucocele of the Appendix: An Unusual Coexistence

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Ioannis Kalogiannidis ◽  
Amalia Mavrona ◽  
Sophia Grammenou ◽  
Georgios Zacharioudakis ◽  
Stamatia Aggelidou ◽  
...  
Keyword(s):  
Histopathological Examination ◽  
Endometrial Adenocarcinoma ◽  
Female Genital Tract ◽  
Mucinous Cystadenoma ◽  
Ct Scanning ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Endometrial Biopsy ◽  
Appendiceal Mucocele ◽  
Preoperative Ct

Appendiceal mucocele is a rare clinical entity, which is however quite often associated with mucinous ovarian tumor. The coexistence of mucinous cystadenoma of the appendix and endometrial adenocarcinoma has not been reported before. A 49-year-old woman presented to our clinic with postmenopausal bleeding and no other symptom. Endometrial biopsy revealed endometrial adenocarcinoma of endometrioid type (grade I). Preoperative CT scanning revealed an appendiceal mucocele, and a colonoscopy confirmed the diagnosis. The patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy and appendectomy. The final histopathological examination showed a mucinous cystadenoma of the appendix and confirmed the diagnosis of endometrioid endometrial adenocarcinoma. The coexistence of appendiceal mucocele and female genital tract pathology is rare. However, gynecologists should keep a high level of suspicion for such possible coexistence. Both the diagnostic approach and the therapeutic management should be multidisciplinary, most importantly with the involvement of general surgeons.

scholarly journals A clinical study of elective hysterectomies for benign lesions

2021 ◽  
Vol 10 (6) ◽  
pp. 2414
Author(s):  
Mamta Meena ◽  
Urvashi . ◽  
C. P. Kachawaha ◽  
Dharmendra Singh Fatehpuriya
Keyword(s):  
Clinical Study ◽  
Vaginal Hysterectomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Safe Procedure ◽  
Benign Lesions ◽  
Duration Of Surgery ◽  
The Mean ◽  
Adnexal Pathology ◽  
Histopathological Report

Background: Hysterectomy is widely used for treating a variety of gynecologic conditions. Most hysterectomies are elective and are performed to treat benign indications. Hence the present study was undertaken to determine the benign indication of hysterectomy, choice of surgical approach, safety and clinical aspect of hysterectomy as a surgical procedure and to correlate the findings with histopathological reports of the specimen.Methods: The present series represents a clinical study of 120 cases of elective hysterectomies for benign lesions. Out of which 73 were done by abdominal and 47 by vaginal route. Finally, all operated specimen were subjected to histological examination.Results: The main indications for elective hysterectomy were leiomyoma 53 (44.2%), prolapse 47 (39.2%) and dysfunctional uterine bleeding 11 (9.2%). Type of operation performed were mainly total abdominal hysterectomy with bilateral salphingo-oophorectomy in 60% cases and vaginal hysterectomy with anterior and posterior repair in 38.3% cases. The mean duration of surgery and average blood loss was more in vaginal procedure (90 min and 100ml) compared to abdominal (70 min and 80ml) respectively. Vaginal hysterectomy was associated with less morbidity and a smoother convalescence than abdominal hysterectomy. In 81.2% cases of abdominal hysterectomies correspondence of indication with histopathological report (HPR) were found, in vaginal 74.5% cases corresponded their histopathological report with their symptoms and investigations. Associated adnexal pathology was found in 8.3% cases. There was no mortality during the whole study period.Conclusions: Hysterectomy for benign pelvic lesions is a safe procedure and an important component of health care for women.

Sentinel node detection in a patient with recurrent endometrial cancer initially treated by hysterectomy and radiotherapy

2004 ◽  
Vol 14 (4) ◽  
pp. 673-676 ◽  
Author(s):  
P. Van Dam ◽  
H. Sonnemans ◽  
P.-J. Van Dam ◽  
D. Smet ◽  
L. Verkinderen ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Sentinel Node ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Pelvic Lymphadenectomy ◽  
Sentinel Node Detection ◽  
Lymph Node Sampling ◽  
Sentinel Node Identification ◽  
Grade Ii ◽  
The Right

This is the first article reporting sentinel node identification in a patient with endometrial cancer recurring in the vagina. A 79-year-old woman presented with a midvaginal recurrence of a stage IB, grade II endometroid carcinoma that had been treated 3 years earlier by a total abdominal hysterectomy, bilateral salpingoophorectomy, and pelvic lymph node sampling, followed by adjuvant brachytherapy to the vaginal vault. A staging examination under anesthetic was performed. Preoperatively, 60-MBq technetium-labeled nannocolloid was injected in the mucosa at 3, 6, 9, and 12 o'clock just adjacent to the tumor recurrence. Three sentinel nodes were detected, respectively, in the left obturator fossa (two) and the right external iliac region, using a laparoscopic probe (Navigator) and removed for pathological assessment. As they proved to be negative, the patient underwent a total vaginectomy, parametrectomy with pelvic lymphadenectomy. The tumor was completely removed, and all lymph nodes proved to be negative. The accuracy of sentinel node identification in patients with recurrent gynecological tumors needs further evaluation. This unique case shows that sentinel node detection is possible after previous radiotherapy and surgery and hopes to stimulate further research in this field.

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