medigraphic.com
SPANISH

Ginecología y Obstetricia de México

Federación Mexicana de Ginecología y Obstetricia, A.C.
  • Contents
  • View Archive
  • Information
    • General Information        
    • Directory
  • Publish
    • Instructions for authors        
  • medigraphic.com
    • Home
    • Journals index            
    • Register / Login
  • Mi perfil

2022, Number 04

<< Back Next >>

Ginecol Obstet Mex 2022; 90 (04)

Endometrial cancer: surgical treatment in a community hospital in Spain

Romero-Matas M, Rodríguez-Pérez A, Caruso A, Polo-Velasco A, Aguilar-Martín V, Rodríguez-Jiménez I, Márquez-Maraver F, Pantoja-Garrido M
Full text How to cite this article

Language: Spanish
References: 25
Page: 307-315
PDF size: 264.01 Kb.


Key words:

Endometrial neoplasms, Minimally invasive surgical, Surgery, Hysterectomy, Lymph node excision.

ABSTRACT

Objective: To expose the surgical outcomes of patients operated on for endometrial cancer, to analyze if there are points of improvement in our clinical practice and to contribute more data to the published evidence, to help advance the surgical treatment of patients with this disease.
Materials and Methods: Observational, descriptive, and retrospective study carried out in the Gynecologic Oncology Unit of the Virgen Macarena Regional Hospital of Seville, Spain, between June 2013 and February 2020. Surgical reports of patients operated on for any premalignant or malignant endometrial condition were collected. Study variables: age, BMI, previous surgeries, histopathological diagnosis and stage, surgical access route and adjuvant therapy. Outcomes related to surgical complications and cure rate are presented, as well as operation time, surgical access route and hospital stay.
Results: 250 patients were studied, the majority (76%) with a diagnosis of endometrioid endometrial adenocarcinoma. The most used surgical access route was laparoscopy (51.6%), with a percentage of intraoperative complications of 10% and postoperative complications of 9.2%. 88.4% of patients remain alive free of disease after treatment, with relapses in only 11.6% and 8% deaths.
Conclusions: The initial treatment of choice in patients with hyperplasia with atypia or early-stage endometrial cancer is surgery, by hysterectomy, double adnexectomy and in some cases associated lymphadenectomy. The choice of surgical approach must be individualized to the conditions of each patient. Laparoscopy offers multiple advantages; it is a technique that is on the rise and is being used more and more frequently.


REFERENCES

  1. Shanmugam S, Thanikachalam R, Murugan A. Comparative study of laparoscopic versus conventional open surgical staging procedure for endometrial cancer: Our institutional experience. Gynecol Minim Invasive Ther 2020; 9:29-33. doi 10.4103/GMIT.GMIT_82_19

  2. Sociedad Española de Ginecología y Obstetricia. Oncoguía cáncer de endometrio 2016. Prog Obstet Ginecol 2017; 60: 274-302.

  3. Pecorelli S. FIGO Committee on Gynecologic Oncology. Revised FIGO staging for carcinoma of the vulva, cervix and endometrium. Int J Gyneaecol Obstet 2009; 105: 103-104. doi: 10.1016/j.ijgo.2009.02.012

  4. Deura I, Shimada M, Azuma Y, Komatsu H, Nagira K, Sawada M et al. Comparison of laparoscopic surgery and conventional laparotomy for surgical staging of patients with presumed low-risk endometrial cancer: The current state of Japan. Taiwan J Obstet Gynecol 2019; 58: 99-104. doi: 10.1016/j.tjog.2018.11.019

  5. Padilla-Iserte P, Lago V, Tauste C, Diaz-Feijoo B, Gil-Moreno A, Oliver R et al. Impact of uterine manipulator on oncological outcome in endometrial cancer surgery. Am J Obstet Gynecol. 2021; 224 (1): 65.e1-65.e11. doi: 10.1016/j. ajog.2020.07.025

  6. Tozzi R, Malur S, Koehler C, Schneider A. Laparoscopy versus laparotomy in endometrial cancer: first analysis of survival of a randomized prospective study. J Minm Invasive Gynecol 2005; 1: 130-6. doi: 10.1016/j.jmig.2005.01.021

  7. Mourits MJ, Bijen CB, Arts HJ, ter Brugge HG, van der Sijde R, Paulsen L et al. Safety of laparoscopy vs laparotomy in earlystage endometrial cancer: a randomized trial. Lancet Oncol 2010; 11: 763-71. doi: 10.1016/S1470-2045(10)70143-1

  8. Chu LH, Chang WC, Sheu BC. Comparison of the laparoscopic versus conventional open method for surgical staging of endometrial carcinoma. Taiwanese J Obstet Gynecol 2016; 55: 188-92. doi: 10.1016/j.tjog.2016.02.007

  9. Colombo N, Creutzberg C, Amant F, Chiva L, Bosse T, González-Martín A et al. ESMO-ESGO-ESTRO Consensus. Conference on endometrial cancer: diagnosis, treatment and follow-up. Int J Gynecol Cancer. 2016; 26: 2-30. doi: 10.1093/annonc/mdv484

  10. Gasparri ML, Caserta D, Benedetti Panici P, Papadia A, Mueller MD. Surgical staging in endometrial cancer. J Cancer Res Clin Oncol. 2019; 145:213-21. doi: 10.1007/ s00432-018-2792-4

  11. Romero Matas M, Pantoja Garrido M, Aguilar Martín V, Polo Velasco A, Jiménez Gallardo J, Rodríguez Jiménez I et al. Biopsia selectiva de ganglio centinela en pacientes con cáncer de endometrio. Inicio de la técnica en el Hospital Universitario Virgen Macarena, Clin Invest Ginecol Obstet. Available online 9 January 2021. https://doi.org/10.1016/j. gine.2020.11.008

  12. Kilts TP, Glaser GE, Langstraat CL, Kumar A, Weaver AL, Mc Gree ME et al. Comparing risk stratification criteria for predicting lymphatic dissemination in endometrial cancer. Gynecol Oncol. 2019; 155:21-6. doi: 10.1016/j. ygyno.2019.08.005

  13. Leiserowitz GS, Xing G, Parikh‑Patel A, Cress R, Abidi A, Rodriguez AO et al. Laparoscopic versus abdominal hysterectomy for endometrial cancer: Comparison of patient outcomes. Int J Gynecol Cancer 2009; 19: 1370‑6. doi: 10.1111/IGC.0b013e3181a83db8

  14. Childers JM, Surwit EA. Combined laparoscopic and vaginal surgery for the management of two cases of stage I endometrial cancer. Gynecol Oncol 1992; 45:46-51. doi: 10.1016/0090-8258(92)90489-6

  15. Walker JL, Piedmonte MR, Spirtos NM, Eisenkop SM, Schlaerth JB, Mannel RS, et al. Recurrence and survival after random assignment to laparoscopy versus laparotomy for comprehensive surgical staging of uterine cancer: Gynecologic Oncology Group LAP2 Study. J Clin Oncol 2012; 30: 695-700. doi: 10.1200/JCO.2011.38.8645

  16. Dowdy SC, Aletti G, Cliby WA, Podratz KC, Mariani A. Extraperitoneal laparoscopic para-aortic lymphadenectomy–a prospective cohort study of 293 patients with endometrial cancer. Gynecol Oncol 2008; 111 (3): 418-24. doi: 10.1016/j. ygyno.2008.08.021

  17. Mouraz M, Ferreira CS, Gonçalves S, Martins NN, Martins FN. Laparoscopic Approach in Surgical Staging of Endometrial Cancer. Rev Bras Ginecol Obstet. 2019; 41 (5): 306-11. doi: 10.1055/s-0039-1688461

  18. Todo Y, Kato H, Kaneuchi M, Watari H, Takeda M, Sakuragi N. Survival effect of para-aortic lymphadenectomy in endometrial cancer (SEPAL study): A retrospective cohort analysis. Lancet 2010; 375: 1165-72. doi: 10.1016/S0140- 6736(09)62002-X

  19. Cohn DE. Endometrial carcinoma: Staging and surgical treatment. UpToDate. Inc. https://www.uptodate.com>. (Consulta: enero de 2021)

  20. Fornalik H, Zore T, Fornalik N, Foster T, Katschke A, Wright G. Can Teamwork and High-Volume Experience Overcome Challenges of Lymphadenectomy in Morbidly Obese Patients (Body Mass Index of 40 kg/m2 or Greater) with Endometrial Cancer? A Cohort Study of Robotics and Laparotomy and Review of Literature. Int J Gynecol Cancer 2018; 28 (5):959-966. doi: 10.1097/IGC.0000000000001255

  21. Eisenhauer EL, Wypych KA, Mehrara BJ, Lawson C, Chi DS, Barakat RR et al. Comparing surgical outcomes in obese women undergoing laparotomy, laparoscopy, or laparotomy with panniculectomy for the staging of uterine malignancy. Ann Surg Oncol 2007; 14 (8): 2384-91. doi: 10.1245/s10434-007-9440-6

  22. Mteta KA, Mbwambo J, Mvungi M. Iatrogenic ureteric and bladder injuries in obstetric and gynaecologic surgeries. East Afr Med J 2006; 83 (2): 79-85.

  23. Bogani G, Raspagliesi F, Maggiore ULR, Mariani A. Current landscape and future perspective of sentinel node mapping in endometrial cancer. J Gynecol Oncol 2018; 29 (6):e94. doi: 10.3802/jgo.2018.29.e94

  24. Niikura H, Tsuji K, Tokunaga H, Shimada M, Ishikawa M, Yaegashi N. Sentinel node navigation surgery in cervical and endometrial cancer: A review. Jpn J Clin Oncol 2019; 49 (6):495-500. doi: 10.1093/jjco/hyz062

  25. Creutzberg CI, van Putten WL. Surgery and post operative RT vs Surgery alone in patients in stage in endometrial cancer. PORTEC Study. Lancet 2000; 55:1404-11. doi: 10.1016 / s0140-6736 (00) 02139-5




2020     |     www.medigraphic.com

Mi perfil

C?MO CITAR (Vancouver)

Ginecol Obstet Mex. 2022;90