[Morbidity of pelvic lymphadenectomy and para-aortic lymphadenectomy in endometrial cancer].
Identifieur interne : 000057 ( France/Analysis ); précédent : 000056; suivant : 000058[Morbidity of pelvic lymphadenectomy and para-aortic lymphadenectomy in endometrial cancer].
Auteurs : Nicolas Agar [France] ; Anne-Cécile Philippe [France] ; Nicolas Bourdel [France] ; Benoît Rabischong [France] ; Michel Canis [France] ; Guillaume Le Bouedec [France] ; Aurélien Mulliez [France] ; Jacques Dauplat [France] ; Christophe Pomel [France]Source :
- Bulletin du cancer [ 1769-6917 ] ; 2015.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Aorte abdominale, Femelle, Humains, Hystérectomie (), Iléus (étiologie), Lymphadénectomie (), Lymphadénectomie (effets indésirables), Lymphocèle (étiologie), Lymphoedème (étiologie), Lésions des nerfs périphériques (étiologie), Membre inférieur, Pelvis, Qualité de vie, Statistique non paramétrique, Sujet âgé, Sujet âgé de 80 ans ou plus, Thromboembolisme veineux (étiologie), Transfusion sanguine (), Tumeurs de l'endomètre (), Tumeurs de l'endomètre (anatomopathologie), Études rétrospectives.
- MESH :
- anatomopathologie : Tumeurs de l'endomètre.
- effets indésirables : Lymphadénectomie.
- étiologie : Iléus, Lymphocèle, Lymphoedème, Lésions des nerfs périphériques, Thromboembolisme veineux.
- Adulte, Adulte d'âge moyen, Aorte abdominale, Femelle, Humains, Hystérectomie, Lymphadénectomie, Membre inférieur, Pelvis, Qualité de vie, Statistique non paramétrique, Sujet âgé, Sujet âgé de 80 ans ou plus, Transfusion sanguine, Tumeurs de l'endomètre, Études rétrospectives.
English descriptors
- KwdEn :
- Adult, Aged, Aged, 80 and over, Aorta, Abdominal, Blood Transfusion (statistics & numerical data), Endometrial Neoplasms (pathology), Endometrial Neoplasms (surgery), Female, Humans, Hysterectomy (methods), Hysterectomy (statistics & numerical data), Ileus (etiology), Lower Extremity, Lymph Node Excision (adverse effects), Lymph Node Excision (methods), Lymph Node Excision (statistics & numerical data), Lymphedema (etiology), Lymphocele (etiology), Middle Aged, Pelvis, Peripheral Nerve Injuries (etiology), Quality of Life, Retrospective Studies, Statistics, Nonparametric, Venous Thromboembolism (etiology).
- MESH :
- adverse effects : Lymph Node Excision.
- etiology : Ileus, Lymphedema, Lymphocele, Peripheral Nerve Injuries, Venous Thromboembolism.
- methods : Hysterectomy, Lymph Node Excision.
- pathology : Endometrial Neoplasms.
- statistics & numerical data : Blood Transfusion, Hysterectomy, Lymph Node Excision.
- surgery : Endometrial Neoplasms.
- Adult, Aged, Aged, 80 and over, Aorta, Abdominal, Female, Humans, Lower Extremity, Middle Aged, Pelvis, Quality of Life, Retrospective Studies, Statistics, Nonparametric.
Abstract
The aim of this study was to evaluate the complication rate of pelvic and para-aortic lymphadenectomy in the management of endometrial cancer following the changes to the recommendations of INCa 2010. This is a retrospective study of 208 patients operated for endometrial cancer between July 2010 and March 2014 in two referral centers. Eighty lymphadenectomy were performed, 65 with hysterectomy and bilateral annexectomy and 18 lymphadenectomy were performed for restaging. Complications assessment is based on the Dindo Clavien classification. We report 17 severe complications (grade 3a and over) (P<0.001), including 14 among patients receiving lymphadenectomy. Morbidity increases with the number of lymphnodes removed and their positivity (P<0.001). The para-aortic lymphadenectomy is primarily responsible for complications (P <0.001). We describe 7 lower limbs lymphedema, 12 nerve injuries, 8 ileus, 5 venous or arterial thromboembolism, 17 blood transfusions, 13 lymphoceles including 9 infected. The rate of intraoperative complications on a first lymphadenectomy is 8% while it reached 22% for restaging. Restaging is significantly more at risk of serious complications (P=0.03) with two deaths. Twenty-four chronic disorders with impaired quality of life (2 without lymphadenectomy) are reported. They are present in 50% of restaging (P=0.033 compared to first lymphadenectomy). Lymphadenectomy is a source of severe morbidity (17.5%) with 2.5% mortality. The benefit of this surgery should probably be discussed again.
DOI: 10.1016/j.bulcan.2015.04.001
PubMed: 25956349
Affiliations:
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pubmed:25956349Le document en format XML
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Université d'Auvergne, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Centre Jean-Perrin, département de chirurgie cancérologique, 58, rue Montalembert, 63058 Clermont-Ferrand, France; Université d'Auvergne</wicri:regionArea><wicri:noRegion>France; Université d'Auvergne</wicri:noRegion><wicri:noRegion>France; Université d'Auvergne</wicri:noRegion></affiliation></author><author><name sortKey="Bourdel, Nicolas" sort="Bourdel, Nicolas" uniqKey="Bourdel N" first="Nicolas" last="Bourdel">Nicolas Bourdel</name><affiliation wicri:level="1"><nlm:affiliation>Hôpital Estaing, département de gynécologie obstétrique, 1, rue Lucie-Aubrac, 63100 Clermont-Ferrand, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Hôpital Estaing, département de gynécologie obstétrique, 1, rue Lucie-Aubrac, 63100 Clermont-Ferrand</wicri:regionArea><wicri:noRegion>63100 Clermont-Ferrand</wicri:noRegion><wicri:noRegion>63100 Clermont-Ferrand</wicri:noRegion></affiliation></author><author><name sortKey="Rabischong, Benoit" sort="Rabischong, Benoit" uniqKey="Rabischong B" first="Benoît" last="Rabischong">Benoît Rabischong</name><affiliation wicri:level="1"><nlm:affiliation>Hôpital Estaing, département de gynécologie obstétrique, 1, rue Lucie-Aubrac, 63100 Clermont-Ferrand, France; Université d'Auvergne, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Hôpital Estaing, département de gynécologie obstétrique, 1, rue Lucie-Aubrac, 63100 Clermont-Ferrand, France; Université d'Auvergne</wicri:regionArea><wicri:noRegion>France; Université d'Auvergne</wicri:noRegion><wicri:noRegion>France; Université d'Auvergne</wicri:noRegion></affiliation></author><author><name sortKey="Canis, Michel" sort="Canis, Michel" uniqKey="Canis M" first="Michel" last="Canis">Michel Canis</name><affiliation wicri:level="1"><nlm:affiliation>Hôpital Estaing, département de gynécologie obstétrique, 1, rue Lucie-Aubrac, 63100 Clermont-Ferrand, France; Université d'Auvergne, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Hôpital Estaing, département de gynécologie obstétrique, 1, rue Lucie-Aubrac, 63100 Clermont-Ferrand, France; Université d'Auvergne</wicri:regionArea><wicri:noRegion>France; Université d'Auvergne</wicri:noRegion><wicri:noRegion>France; Université d'Auvergne</wicri:noRegion></affiliation></author><author><name sortKey="Le Bouedec, Guillaume" sort="Le Bouedec, Guillaume" uniqKey="Le Bouedec G" first="Guillaume" last="Le Bouedec">Guillaume Le Bouedec</name><affiliation wicri:level="1"><nlm:affiliation>Centre Jean-Perrin, département de chirurgie cancérologique, 58, rue Montalembert, 63058 Clermont-Ferrand, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Centre Jean-Perrin, département de chirurgie cancérologique, 58, rue Montalembert, 63058 Clermont-Ferrand</wicri:regionArea><wicri:noRegion>63058 Clermont-Ferrand</wicri:noRegion><wicri:noRegion>63058 Clermont-Ferrand</wicri:noRegion></affiliation></author><author><name sortKey="Mulliez, Aurelien" sort="Mulliez, Aurelien" uniqKey="Mulliez A" first="Aurélien" last="Mulliez">Aurélien Mulliez</name><affiliation wicri:level="1"><nlm:affiliation>Délégation recherche clinique et innovation, 58, rue Montalembert, 63003 Clermont-Ferrand cedex, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Délégation recherche clinique et innovation, 58, rue Montalembert, 63003 Clermont-Ferrand cedex</wicri:regionArea><wicri:noRegion>63003 Clermont-Ferrand cedex</wicri:noRegion><wicri:noRegion>63003 Clermont-Ferrand cedex</wicri:noRegion></affiliation></author><author><name sortKey="Dauplat, Jacques" sort="Dauplat, Jacques" uniqKey="Dauplat J" first="Jacques" last="Dauplat">Jacques Dauplat</name><affiliation wicri:level="1"><nlm:affiliation>Centre Jean-Perrin, département de chirurgie cancérologique, 58, rue Montalembert, 63058 Clermont-Ferrand, France; Université d'Auvergne, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Centre Jean-Perrin, département de chirurgie cancérologique, 58, rue Montalembert, 63058 Clermont-Ferrand, France; Université d'Auvergne</wicri:regionArea><wicri:noRegion>France; Université d'Auvergne</wicri:noRegion><wicri:noRegion>France; Université d'Auvergne</wicri:noRegion></affiliation></author><author><name sortKey="Pomel, Christophe" sort="Pomel, Christophe" uniqKey="Pomel C" first="Christophe" last="Pomel">Christophe Pomel</name><affiliation wicri:level="1"><nlm:affiliation>Centre Jean-Perrin, département de chirurgie cancérologique, 58, rue Montalembert, 63058 Clermont-Ferrand, France; Université d'Auvergne, France. Electronic address: christophe.pomel@cjp.fr.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Centre Jean-Perrin, département de chirurgie cancérologique, 58, rue Montalembert, 63058 Clermont-Ferrand, France; Université d'Auvergne</wicri:regionArea><wicri:noRegion>France; Université d'Auvergne</wicri:noRegion><wicri:noRegion>France; Université d'Auvergne</wicri:noRegion></affiliation></author></analytic><series><title level="j">Bulletin du cancer</title><idno type="eISSN">1769-6917</idno><imprint><date when="2015" type="published">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Aorta, Abdominal</term><term>Blood Transfusion (statistics & numerical data)</term><term>Endometrial Neoplasms (pathology)</term><term>Endometrial Neoplasms (surgery)</term><term>Female</term><term>Humans</term><term>Hysterectomy (methods)</term><term>Hysterectomy (statistics & numerical data)</term><term>Ileus (etiology)</term><term>Lower Extremity</term><term>Lymph Node Excision (adverse effects)</term><term>Lymph Node Excision (methods)</term><term>Lymph Node Excision (statistics & numerical data)</term><term>Lymphedema (etiology)</term><term>Lymphocele (etiology)</term><term>Middle Aged</term><term>Pelvis</term><term>Peripheral Nerve Injuries (etiology)</term><term>Quality of Life</term><term>Retrospective Studies</term><term>Statistics, Nonparametric</term><term>Venous Thromboembolism (etiology)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Aorte abdominale</term><term>Femelle</term><term>Humains</term><term>Hystérectomie ()</term><term>Iléus (étiologie)</term><term>Lymphadénectomie ()</term><term>Lymphadénectomie (effets indésirables)</term><term>Lymphocèle (étiologie)</term><term>Lymphoedème (étiologie)</term><term>Lésions des nerfs périphériques (étiologie)</term><term>Membre inférieur</term><term>Pelvis</term><term>Qualité de vie</term><term>Statistique non paramétrique</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Thromboembolisme veineux (étiologie)</term><term>Transfusion sanguine ()</term><term>Tumeurs de l'endomètre ()</term><term>Tumeurs de l'endomètre (anatomopathologie)</term><term>Études rétrospectives</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Lymph Node Excision</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Tumeurs de l'endomètre</term></keywords><keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Lymphadénectomie</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Ileus</term><term>Lymphedema</term><term>Lymphocele</term><term>Peripheral Nerve Injuries</term><term>Venous Thromboembolism</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Hysterectomy</term><term>Lymph Node Excision</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Endometrial Neoplasms</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Blood Transfusion</term><term>Hysterectomy</term><term>Lymph Node Excision</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Endometrial Neoplasms</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Iléus</term><term>Lymphocèle</term><term>Lymphoedème</term><term>Lésions des nerfs périphériques</term><term>Thromboembolisme veineux</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Aorta, Abdominal</term><term>Female</term><term>Humans</term><term>Lower Extremity</term><term>Middle Aged</term><term>Pelvis</term><term>Quality of Life</term><term>Retrospective Studies</term><term>Statistics, Nonparametric</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Aorte abdominale</term><term>Femelle</term><term>Humains</term><term>Hystérectomie</term><term>Lymphadénectomie</term><term>Membre inférieur</term><term>Pelvis</term><term>Qualité de vie</term><term>Statistique non paramétrique</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Transfusion sanguine</term><term>Tumeurs de l'endomètre</term><term>Études rétrospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The aim of this study was to evaluate the complication rate of pelvic and para-aortic lymphadenectomy in the management of endometrial cancer following the changes to the recommendations of INCa 2010. This is a retrospective study of 208 patients operated for endometrial cancer between July 2010 and March 2014 in two referral centers. Eighty lymphadenectomy were performed, 65 with hysterectomy and bilateral annexectomy and 18 lymphadenectomy were performed for restaging. Complications assessment is based on the Dindo Clavien classification. We report 17 severe complications (grade 3a and over) (P<0.001), including 14 among patients receiving lymphadenectomy. Morbidity increases with the number of lymphnodes removed and their positivity (P<0.001). The para-aortic lymphadenectomy is primarily responsible for complications (P <0.001). We describe 7 lower limbs lymphedema, 12 nerve injuries, 8 ileus, 5 venous or arterial thromboembolism, 17 blood transfusions, 13 lymphoceles including 9 infected. The rate of intraoperative complications on a first lymphadenectomy is 8% while it reached 22% for restaging. Restaging is significantly more at risk of serious complications (P=0.03) with two deaths. Twenty-four chronic disorders with impaired quality of life (2 without lymphadenectomy) are reported. They are present in 50% of restaging (P=0.033 compared to first lymphadenectomy). Lymphadenectomy is a source of severe morbidity (17.5%) with 2.5% mortality. The benefit of this surgery should probably be discussed again.</div></front></TEI><affiliations><list><country><li>France</li></country><region><li>Auvergne (région administrative)</li><li>Auvergne-Rhône-Alpes</li></region><settlement><li>Clermont-Ferrand</li></settlement></list><tree><country name="France"><region name="Auvergne-Rhône-Alpes"><name sortKey="Agar, Nicolas" sort="Agar, Nicolas" uniqKey="Agar N" first="Nicolas" last="Agar">Nicolas Agar</name></region><name sortKey="Bourdel, Nicolas" sort="Bourdel, Nicolas" uniqKey="Bourdel N" first="Nicolas" last="Bourdel">Nicolas Bourdel</name><name sortKey="Canis, Michel" sort="Canis, Michel" uniqKey="Canis M" first="Michel" last="Canis">Michel Canis</name><name sortKey="Dauplat, Jacques" sort="Dauplat, Jacques" uniqKey="Dauplat J" first="Jacques" last="Dauplat">Jacques Dauplat</name><name sortKey="Le Bouedec, Guillaume" sort="Le Bouedec, Guillaume" uniqKey="Le Bouedec G" first="Guillaume" last="Le Bouedec">Guillaume Le Bouedec</name><name sortKey="Mulliez, Aurelien" sort="Mulliez, Aurelien" uniqKey="Mulliez A" first="Aurélien" last="Mulliez">Aurélien Mulliez</name><name sortKey="Philippe, Anne Cecile" sort="Philippe, Anne Cecile" uniqKey="Philippe A" first="Anne-Cécile" last="Philippe">Anne-Cécile Philippe</name><name sortKey="Pomel, Christophe" sort="Pomel, Christophe" uniqKey="Pomel C" first="Christophe" last="Pomel">Christophe Pomel</name><name sortKey="Rabischong, Benoit" sort="Rabischong, Benoit" uniqKey="Rabischong B" first="Benoît" last="Rabischong">Benoît Rabischong</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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