What’s New in Gynaecological Oncology?

2011 ◽  
Vol 07 (03) ◽  
pp. 188
Author(s):  
Giovanni Di Vagno ◽  
Keyword(s):  
Endometrial Cancer ◽  
Lymph Node ◽  
High Risk ◽  
Preterm Delivery ◽  
Lymph Node Dissection ◽  
Ca 125 ◽  
Optimal Cytoreduction ◽  
Node Dissection ◽  
Aortic Lymph Node ◽  
Hpv Genotypes

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.

scholarly journals Sentinel lymph node biopsy guided by indocyanine green dye in endometrial cancer patients: literature review and clinical experience

2019 ◽  
Vol 18 (2) ◽  
pp. 52-57
Author(s):  
A. V. Kochatkov ◽  
N. S. Kharlov
Keyword(s):  
Endometrial Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Indocyanine Green ◽  
Cancer Patients ◽  
Lymph Node Dissection ◽  
Node Dissection ◽  
Indocyanine Green Dye ◽  
Duration Of Surgery ◽  
Aortic Lymph Node

The purpose of the study was to assess the feasibility and safety of using the technique of intraoperative sentinel lymph node (slN) detection guided by indocyanine green dye in endometrial cancer patients.Material and methods. The study included 10 patients with stage i–ii/g1–2 endometrial cancer. the mean age of the patients was 66.2 years. laser-assisted indocyanine green (icg) fluorescent dye was used for slN mapping. icgwas injected into the uterine cervix immediately before surgery. the concentration used for icgwas 1.25 mg/ml (a 25 mg vial with icgpowder was diluted into 20 cc of aqueous sterile water. icgwas injected intracervically at 3 and 9 o’clock positions: 0.5 ml at 5 mm depth and 0.5 ml at 10 mm depth. the pinpoint endoscopic fluorescence imaging system (Novadaq, canada) was used for slN mapping.Results. SLNs were identified and removed in all patients. SLNs were located along the external iliac vessels in 6 patients and in the obturator fossa and in the hypogastric vessels in 4 patients. an additional para-aortic lymph node was visualized in one case. Both urgent and planned histological examinations showed no evidence of metastases in all patients. pelvic lymph node dissection was performed in 4 patients. combined pelvic and para-aortic lymph node dissection was performed in one case.Conclusion. Lymph node involvement is an important prognostic factor in deciding whether neoadjuvant chemotherapy is necessary for endometrial cancer patients. the technique of slN detection using indocyanine green dye appears promising in ensuring adequate intraoperative staging and optimization of the extent and duration of surgery. the use of this algorithm for the treatment of endometrial cancer will significantly reduce the risk of perioperative complications associated with lymphadenectomy, not negatively influencing the disease outcome.

Para-aortic Lymph Node Dissection for Women With Endometrial Adenocarcinoma and Intermediate- to High-Risk Tumors: Does It Improve Survival?

2014 ◽  
Vol 24 (1) ◽  
pp. 91-96 ◽  
Author(s):  
Madeleine Courtney-Brooks ◽  
Jennifer M. Scalici ◽  
A. Rauda Tellawi ◽  
Leigh A. Cantrell ◽  
Linda R. Duska
Keyword(s):  
Lymph Node ◽  
High Risk ◽  
Lymph Node Dissection ◽  
Endometrial Adenocarcinoma ◽  
Univariate Analysis ◽  
Therapeutic Benefit ◽  
Pelvic Lymphadenectomy ◽  
Node Dissection ◽  
Medical Comorbidities ◽  
Aortic Lymph Node

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.

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