Implications of a two-step procedure in surgical management of patients with early-stage endometrioid endometrial cancer

• Published in: Journal of gynecologic oncology 2015, 26(2), , pp.125-133
• Main Authors: Arsène, Emmanuelle, Bleu, Géraldine, Merlot, Benjamin, Boulanger, Loïc, Vinatier, Denis, Kerdraon, Olivier, Collinet, Pierre
• Format: Article
• Language: English
• Subjects: Aged; Carcinoma, Endometrioid - epidemiology; Carcinoma, Endometrioid - pathology; Carcinoma, Endometrioid - surgery; Endometrial Neoplasms - epidemiology; Endometrial Neoplasms - pathology; Endometrial Neoplasms - surgery; Female; Humans; Hysterectomy - methods; Hysterectomy - statistics & numerical data; Life Sciences; Lymph Node Excision - methods; Lymph Node Excision - standards; Lymph Node Excision - statistics & numerical data; Middle Aged; Morbidity; Neoplasm Staging - standards; Original; Pelvis; Postoperative Complications - epidemiology; Prognosis; Reoperation - statistics & numerical data; Retrospective Studies; Salpingectomy - methods; Salpingectomy - statistics & numerical data; 산부인과학
• ISSN: 2005-0380; 2005-0399; 2005-0399
• DOI: 10.3802/jgo.2015.26.2.125

Since European Society for Medical Oncology (ESMO) recommendations and French guidelines, pelvic lymphadenectomy should not be systematically performed for women with early-stage endometrioid endometrial cancer (EEC) preoperatively assessed at presumed low- or intermediate-risk. The aim of our study was to evaluate the change of our surgical practices after ESMO recommendations, and to evaluate the rate and morbidity of second surgical procedure in case of understaging after the first surgery. This retrospective single-center study included women with EEC preoperatively assessed at presumed low- or intermediate-risk who had surgery between 2006 and 2013. Two periods were defined the times before and after ESMO recommendations. Demographics characteristics, surgical management, operative morbidity, and rate of understaging were compared. The rate of second surgical procedure required for lymph node resection during the second period and its morbidity were also studied. Sixty-one and sixty-two patients were operated for EEC preoperatively assessed at presumed low-or intermediate-risk before and after ESMO recommendations, respectively. Although immediate pelvic lymphadenectomy was performed more frequently during the first period than the second period (88.5% vs. 19.4%; p