Managing Endometrial Cancer: The Role of Pelvic Lymphadenectomy and Secondary Surgery. Borghesi, Y., Narducci, F., Bresson, L., Tresch, E., Meurant, J. P., Cousin, S., Cordoba, A., Merlot, B., & Leblanc, E. Ann Surg Oncol, 22 Suppl 3:S936–43, 2015. ![Managing Endometrial Cancer: The Role of Pelvic Lymphadenectomy and Secondary Surgery [link]](https://bibbase.org/img/filetypes/link.svg "link")
Paper doi abstract bibtex PURPOSE: In November 2010, the French National Cancer Institute published new guidelines for managing endometrial cancer. Pelvic lymphadenectomy is not indicated for preoperative low-intermediate risk type 1 endometrial cancer, and high-risk patients should undergo secondary surgery with para-aortic lymphadenectomy. This study evaluated these new guidelines with regard to overall survival (OS), relapse-free survival (RFS), and morbidity for patients with low-intermediate risk disease. METHODS: We evaluated all type 1 endometrial cancer patients with low-intermediate risk of recurrence who were treated from 1 January 1997 through 31 December 2012. All patients were classified according to the 2009 International Federation of Gynecology and Obstetrics staging criteria and the European Society for Medical Oncology. RESULTS: Overall, 230 patients were included (159 before and 71 after the new guidelines were issued). Pelvic lymphadenectomies were performed before and after the new guidelines in 77.4 and 28.6 % of patients, respectively (p \textbackslashtextbackslashtextless 0.001). After 2010, eight patients also underwent secondary surgery, which consisted of a para-aortic lymphadenectomy for lymphovascular space invasion (LVSI). This second surgery changed the adjuvant treatment for one patient. OS and RFS were similar between both groups, and no difference in morbidity was observed between the groups. LVSI was an independent factor for OS [hazard ratio (HR) 7.2, 95 % CI 3.1-17; p \textbackslashtextbackslashtextless 0.001] and RFS (HR 3.7, 95 % CI 1.6-8.5; p \textbackslashtextbackslashtextless 0.003). CONCLUSIONS: Fewer pelvic lymphadenectomies in low-intermediate risk patients did not affect OS, RFS, or morbidity, including patients with secondary surgery. We must gather additional data with a longer follow-up period to not only confirm our results but to also fully investigate the paradoxical absence of decreased morbidity that our study has shown.
@article{borghesi_managing_2015,
title = {Managing {Endometrial} {Cancer}: {The} {Role} of {Pelvic} {Lymphadenectomy} and {Secondary} {Surgery}},
volume = {22 Suppl 3},
issn = {1534-4681 (Electronic) 1068-9265 (Linking)},
url = {http://www.ncbi.nlm.nih.gov/pubmed/26305024},
doi = {10.1245/s10434-015-4798-3},
abstract = {PURPOSE: In November 2010, the French National Cancer Institute published new guidelines for managing endometrial cancer. Pelvic lymphadenectomy is not indicated for preoperative low-intermediate risk type 1 endometrial cancer, and high-risk patients should undergo secondary surgery with para-aortic lymphadenectomy. This study evaluated these new guidelines with regard to overall survival (OS), relapse-free survival (RFS), and morbidity for patients with low-intermediate risk disease. METHODS: We evaluated all type 1 endometrial cancer patients with low-intermediate risk of recurrence who were treated from 1 January 1997 through 31 December 2012. All patients were classified according to the 2009 International Federation of Gynecology and Obstetrics staging criteria and the European Society for Medical Oncology. RESULTS: Overall, 230 patients were included (159 before and 71 after the new guidelines were issued). Pelvic lymphadenectomies were performed before and after the new guidelines in 77.4 and 28.6 \% of patients, respectively (p {\textbackslash}textbackslashtextless 0.001). After 2010, eight patients also underwent secondary surgery, which consisted of a para-aortic lymphadenectomy for lymphovascular space invasion (LVSI). This second surgery changed the adjuvant treatment for one patient. OS and RFS were similar between both groups, and no difference in morbidity was observed between the groups. LVSI was an independent factor for OS [hazard ratio (HR) 7.2, 95 \% CI 3.1-17; p {\textbackslash}textbackslashtextless 0.001] and RFS (HR 3.7, 95 \% CI 1.6-8.5; p {\textbackslash}textbackslashtextless 0.003). CONCLUSIONS: Fewer pelvic lymphadenectomies in low-intermediate risk patients did not affect OS, RFS, or morbidity, including patients with secondary surgery. We must gather additional data with a longer follow-up period to not only confirm our results but to also fully investigate the paradoxical absence of decreased morbidity that our study has shown.},
journal = {Ann Surg Oncol},
author = {Borghesi, Y. and Narducci, F. and Bresson, L. and Tresch, E. and Meurant, J. P. and Cousin, S. and Cordoba, A. and Merlot, B. and Leblanc, E.},
year = {2015},
keywords = {*Practice Guidelines as Topic, *Second-Look Surgery, Aged, Cohort Studies, Disease Management, Endometrial Neoplasms/pathology/*surgery, Female, Follow-Up Studies, Humans, Lymphatic Metastasis, Middle Aged, Neoplasm Grading, Neoplasm Invasiveness, Neoplasm Staging, Pelvic Neoplasms/secondary/*surgery, Prognosis, Survival Rate},
pages = {S936--43},
}
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P.","Cousin, S.","Cordoba, A.","Merlot, B.","Leblanc, E."],"year":2015,"bibtype":"article","biburl":"https://api.zotero.org/users/4915350/collections/YPPRWHHG/items?key=9UQuiwltMdY02lUFuEAB0dvL&format=bibtex&limit=100","bibdata":{"bibtype":"article","type":"article","title":"Managing Endometrial Cancer: The Role of Pelvic Lymphadenectomy and Secondary Surgery","volume":"22 Suppl 3","issn":"1534-4681 (Electronic) 1068-9265 (Linking)","url":"http://www.ncbi.nlm.nih.gov/pubmed/26305024","doi":"10.1245/s10434-015-4798-3","abstract":"PURPOSE: In November 2010, the French National Cancer Institute published new guidelines for managing endometrial cancer. Pelvic lymphadenectomy is not indicated for preoperative low-intermediate risk type 1 endometrial cancer, and high-risk patients should undergo secondary surgery with para-aortic lymphadenectomy. This study evaluated these new guidelines with regard to overall survival (OS), relapse-free survival (RFS), and morbidity for patients with low-intermediate risk disease. METHODS: We evaluated all type 1 endometrial cancer patients with low-intermediate risk of recurrence who were treated from 1 January 1997 through 31 December 2012. All patients were classified according to the 2009 International Federation of Gynecology and Obstetrics staging criteria and the European Society for Medical Oncology. RESULTS: Overall, 230 patients were included (159 before and 71 after the new guidelines were issued). Pelvic lymphadenectomies were performed before and after the new guidelines in 77.4 and 28.6 % of patients, respectively (p \\textbackslashtextbackslashtextless 0.001). After 2010, eight patients also underwent secondary surgery, which consisted of a para-aortic lymphadenectomy for lymphovascular space invasion (LVSI). This second surgery changed the adjuvant treatment for one patient. OS and RFS were similar between both groups, and no difference in morbidity was observed between the groups. LVSI was an independent factor for OS [hazard ratio (HR) 7.2, 95 % CI 3.1-17; p \\textbackslashtextbackslashtextless 0.001] and RFS (HR 3.7, 95 % CI 1.6-8.5; p \\textbackslashtextbackslashtextless 0.003). CONCLUSIONS: Fewer pelvic lymphadenectomies in low-intermediate risk patients did not affect OS, RFS, or morbidity, including patients with secondary surgery. We must gather additional data with a longer follow-up period to not only confirm our results but to also fully investigate the paradoxical absence of decreased morbidity that our study has shown.","journal":"Ann Surg Oncol","author":[{"propositions":[],"lastnames":["Borghesi"],"firstnames":["Y."],"suffixes":[]},{"propositions":[],"lastnames":["Narducci"],"firstnames":["F."],"suffixes":[]},{"propositions":[],"lastnames":["Bresson"],"firstnames":["L."],"suffixes":[]},{"propositions":[],"lastnames":["Tresch"],"firstnames":["E."],"suffixes":[]},{"propositions":[],"lastnames":["Meurant"],"firstnames":["J.","P."],"suffixes":[]},{"propositions":[],"lastnames":["Cousin"],"firstnames":["S."],"suffixes":[]},{"propositions":[],"lastnames":["Cordoba"],"firstnames":["A."],"suffixes":[]},{"propositions":[],"lastnames":["Merlot"],"firstnames":["B."],"suffixes":[]},{"propositions":[],"lastnames":["Leblanc"],"firstnames":["E."],"suffixes":[]}],"year":"2015","keywords":"*Practice Guidelines as Topic, *Second-Look Surgery, Aged, Cohort Studies, Disease Management, Endometrial Neoplasms/pathology/*surgery, Female, Follow-Up Studies, Humans, Lymphatic Metastasis, Middle Aged, Neoplasm Grading, Neoplasm Invasiveness, Neoplasm Staging, Pelvic Neoplasms/secondary/*surgery, Prognosis, Survival Rate","pages":"S936–43","bibtex":"@article{borghesi_managing_2015,\n\ttitle = {Managing {Endometrial} {Cancer}: {The} {Role} of {Pelvic} {Lymphadenectomy} and {Secondary} {Surgery}},\n\tvolume = {22 Suppl 3},\n\tissn = {1534-4681 (Electronic) 1068-9265 (Linking)},\n\turl = {http://www.ncbi.nlm.nih.gov/pubmed/26305024},\n\tdoi = {10.1245/s10434-015-4798-3},\n\tabstract = {PURPOSE: In November 2010, the French National Cancer Institute published new guidelines for managing endometrial cancer. Pelvic lymphadenectomy is not indicated for preoperative low-intermediate risk type 1 endometrial cancer, and high-risk patients should undergo secondary surgery with para-aortic lymphadenectomy. This study evaluated these new guidelines with regard to overall survival (OS), relapse-free survival (RFS), and morbidity for patients with low-intermediate risk disease. METHODS: We evaluated all type 1 endometrial cancer patients with low-intermediate risk of recurrence who were treated from 1 January 1997 through 31 December 2012. All patients were classified according to the 2009 International Federation of Gynecology and Obstetrics staging criteria and the European Society for Medical Oncology. RESULTS: Overall, 230 patients were included (159 before and 71 after the new guidelines were issued). Pelvic lymphadenectomies were performed before and after the new guidelines in 77.4 and 28.6 \\% of patients, respectively (p {\\textbackslash}textbackslashtextless 0.001). After 2010, eight patients also underwent secondary surgery, which consisted of a para-aortic lymphadenectomy for lymphovascular space invasion (LVSI). This second surgery changed the adjuvant treatment for one patient. OS and RFS were similar between both groups, and no difference in morbidity was observed between the groups. LVSI was an independent factor for OS [hazard ratio (HR) 7.2, 95 \\% CI 3.1-17; p {\\textbackslash}textbackslashtextless 0.001] and RFS (HR 3.7, 95 \\% CI 1.6-8.5; p {\\textbackslash}textbackslashtextless 0.003). CONCLUSIONS: Fewer pelvic lymphadenectomies in low-intermediate risk patients did not affect OS, RFS, or morbidity, including patients with secondary surgery. We must gather additional data with a longer follow-up period to not only confirm our results but to also fully investigate the paradoxical absence of decreased morbidity that our study has shown.},\n\tjournal = {Ann Surg Oncol},\n\tauthor = {Borghesi, Y. and Narducci, F. and Bresson, L. and Tresch, E. and Meurant, J. P. and Cousin, S. and Cordoba, A. and Merlot, B. and Leblanc, E.},\n\tyear = {2015},\n\tkeywords = {*Practice Guidelines as Topic, *Second-Look Surgery, Aged, Cohort Studies, Disease Management, Endometrial Neoplasms/pathology/*surgery, Female, Follow-Up Studies, Humans, Lymphatic Metastasis, Middle Aged, Neoplasm Grading, Neoplasm Invasiveness, Neoplasm Staging, Pelvic Neoplasms/secondary/*surgery, Prognosis, Survival Rate},\n\tpages = {S936--43},\n}\n\n","author_short":["Borghesi, Y.","Narducci, F.","Bresson, L.","Tresch, E.","Meurant, J. 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