Impact of Lymphadenectomy on Short- and Long-term Complications in Patients With Endometrial Cancer

Abstract IntroductionEarly endometrial cancer is primarily treated surgically via hysterectomy, adenectomy and, depending on tumor stage and subtype, lymphadenectomy. Systematic lymph node dissection is known to cause surgical complications. The aim of the present study was to investigate morbidity and mortality rates associated with lymphadenectomy in patients with endometrial cancer who underwent surgery in a routine clinical setting.MethodsWe collected data from 232 patients who were operated for endometrial carcinoma between 2006 and 2018 at the University of Luebeck, Germany. Surgical complications were viewed in relation to surgical risk factors. Additionally, a questionnaire concerning long-term lymphatic complications and survival was completed. Survival was compared between patients who underwent lymphadenectomy (group I) and those who did not (group II). Results Patients in group I needed revision surgery significantly more often due to postoperative complications (such as lymphoceles) compared to those in group II (p = 0.01). The results indicate more serious complications in patients who underwent a systematic lymphadenectomy and in those with lymph node metastases.15 % of patients who underwent a systematic lymphadenectomy had lymph node metastases. Recurrences occurred in 12.5 % of cases and were significantly more frequent in patients who had undergone a lymphadenectomy, even if the lymph nodes were negative (p = 0.02). A comparison of survival data during the follow-up period revealed no significant difference.The study highlighted the need for a better preoperative risk stratification and the avoidance of lymphadenectomy for surgical staging alone.

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Evolution of differentiated thyroid cancer during pregnancy in a community University Hospital in Buenos Aires, Argentina

Arquivos Brasileiros de Endocrinologia & Metabologia ◽

10.1590/s0004-27302013000400005 ◽

2013 ◽

Vol 57 (4) ◽

pp. 307-311 ◽

Cited By ~ 4

Author(s):

Carmen Amalia Cabezón ◽

Laura Carolina Carrizo ◽

Pablo René Costanzo

Keyword(s):

Thyroid Cancer ◽

Lymph Node ◽

Lymph Node Metastases ◽

Tumor Size ◽

Differentiated Thyroid Cancer ◽

Whole Body ◽

Group I ◽

Node Metastases ◽

Group Ii

OBJECTIVE: To analyze the presentation, follow-up and evolution of differentiated thyroid cancer (DTC) detected during pregnancy. SUBJECTS AND METHODS: Twenty nine women with DTC detected during pregnancy were analyzed. Group I (n = 13) was seen during pregnancy and DTC was diagnosed during gestation; detection of the nodule occurred during pregnancy (first trimester). Group II (n = 16) was seen after delivery; detection of the nodule occurred during pregnancy (second or third trimester). Complete thyroidectomy, ablative dose of radioactive iodine, and treatment with levothyroxine were performed. Follow-up: neck ultrasound; TSH, free T4, thyroglobulin, and anti-thyroglobulin antibodies with and without treatment with levothyroxine; and 131I whole body scans. Histological diagnosis, lymph node metastases, tumor size and stage, complications from pregnancy, and DTC evolution were evaluated. RESULTS: 100% of the patients had papillary thyroid carcinoma. Lymph node metastases were detected in 13 (44.8%), and invasion of adjacent extrathyroid tissue in 2 patients. Tumor size was larger in Group II: 22.1 ± 10.9 versus 13.9 ± 3.5 mm; p = 0.03. No differences were found in the tumor stages between groups. All patients had full-term pregnancies and healthy newborns. Follow-up: 5.7 ± 4.3 years; one patient had persistent disease. CONCLUSIONS: DTC detected during pregnancy had a favorable evolution. Surgery may be postponed to the post-delivery period, unless there are risk factors that justify it during pregnancy.

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