Clinical Stage I adenocarcinoma of the endometrium—Analysis of recurrences and the potential benefit of staging lymphadenectomy
Identifieur interne : 004253 ( Istex/Corpus ); précédent : 004252; suivant : 004254Clinical Stage I adenocarcinoma of the endometrium—Analysis of recurrences and the potential benefit of staging lymphadenectomy
Auteurs : Jerome L. Belinson ; Kenneth R. Lee ; Gary J. Badger ; Robert G. Pretorius ; Maureen A. JarrellSource :
- Gynecologic Oncology [ 0090-8258 ] ; 1992.
Abstract
Two hundred forty-eight consecutive patients with clinical Stage I adenocarcinoma of the endometrium were seen between 877 and 888. Twenty-one were medically not operable and eleven others had papillary serous tumors. The remaining 216 were managed by a consistent operative protocol except that routine preoperative cesium was discontinued after 1283. Patients received postoperative pelvic radiation on the basis of the depth of invasion, extrauterine pelvic disease, and/or cervix involvement. No patient underwent a pelvic lymphadenectomy. Only palpably suspicious nodes were removed. Twenty-one of these two hundred sixteen patients developed a recurrence. These 21 cases are analyzed for the probability of a staging lymphadenectomy having prevented their recurrence. Median follow-up of all 216 patients is 61 months with a mean time to recurrence of 26.5 months. No patient was lost to follow-up. Patients who recurred are analyzed by grade, depth of invasion, surgical stage, time to recurrence, site of recurrence, survival, protocol breaks, and frozen section discrepancies. No patient recurred on the pelvic sidewall. All patients found to have positive para-aortic nodes have died. No patient who received vaginal and/or pelvic radiation recurred in the pelvis. We conclude that staging lymphadenectomy would not have improved the outcome for these patients.
Url:
DOI: 10.1016/0090-8258(92)90005-4
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title>Clinical Stage I adenocarcinoma of the endometrium—Analysis of recurrences and the potential benefit of staging lymphadenectomy</title><author><name sortKey="Belinson, Jerome L" sort="Belinson, Jerome L" uniqKey="Belinson J" first="Jerome L." last="Belinson">Jerome L. Belinson</name><affiliation><mods:affiliation>Department of Obstetrics and Gynecology, University of Vermont, Burlington, Vermont 05401 USA</mods:affiliation></affiliation></author><author><name sortKey="Lee, Kenneth R" sort="Lee, Kenneth R" uniqKey="Lee K" first="Kenneth R." last="Lee">Kenneth R. Lee</name><affiliation><mods:affiliation>Department of Biometry, University of Vermont, Burlington, Vermont 05401 USA</mods:affiliation></affiliation></author><author><name sortKey="Badger, Gary J" sort="Badger, Gary J" uniqKey="Badger G" first="Gary J." last="Badger">Gary J. Badger</name><affiliation><mods:affiliation>Vermont Regional Cancer Center, University of Vermont, Burlington, Vermont 05401 USA</mods:affiliation></affiliation></author><author><name sortKey="Pretorius, Robert G" sort="Pretorius, Robert G" uniqKey="Pretorius R" first="Robert G." last="Pretorius">Robert G. Pretorius</name><affiliation><mods:affiliation>Department of Obstetrics and Gynecology, University of Vermont, Burlington, Vermont 05401 USA</mods:affiliation></affiliation></author><author><name sortKey="Jarrell, Maureen A" sort="Jarrell, Maureen A" uniqKey="Jarrell M" first="Maureen A." last="Jarrell">Maureen A. 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Belinson</name><affiliation><mods:affiliation>Department of Obstetrics and Gynecology, University of Vermont, Burlington, Vermont 05401 USA</mods:affiliation></affiliation></author><author><name sortKey="Lee, Kenneth R" sort="Lee, Kenneth R" uniqKey="Lee K" first="Kenneth R." last="Lee">Kenneth R. Lee</name><affiliation><mods:affiliation>Department of Biometry, University of Vermont, Burlington, Vermont 05401 USA</mods:affiliation></affiliation></author><author><name sortKey="Badger, Gary J" sort="Badger, Gary J" uniqKey="Badger G" first="Gary J." last="Badger">Gary J. Badger</name><affiliation><mods:affiliation>Vermont Regional Cancer Center, University of Vermont, Burlington, Vermont 05401 USA</mods:affiliation></affiliation></author><author><name sortKey="Pretorius, Robert G" sort="Pretorius, Robert G" uniqKey="Pretorius R" first="Robert G." last="Pretorius">Robert G. Pretorius</name><affiliation><mods:affiliation>Department of Obstetrics and Gynecology, University of Vermont, Burlington, Vermont 05401 USA</mods:affiliation></affiliation></author><author><name sortKey="Jarrell, Maureen A" sort="Jarrell, Maureen A" uniqKey="Jarrell M" first="Maureen A." last="Jarrell">Maureen A. Jarrell</name><affiliation><mods:affiliation>Department of Obstetrics and Gynecology, University of Vermont, Burlington, Vermont 05401 USA</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Gynecologic Oncology</title><title level="j" type="abbrev">YGYNO</title><idno type="ISSN">0090-8258</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1992">1992</date><biblScope unit="volume">44</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="17">17</biblScope><biblScope unit="page" to="23">23</biblScope></imprint><idno type="ISSN">0090-8258</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0090-8258</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Two hundred forty-eight consecutive patients with clinical Stage I adenocarcinoma of the endometrium were seen between 877 and 888. Twenty-one were medically not operable and eleven others had papillary serous tumors. The remaining 216 were managed by a consistent operative protocol except that routine preoperative cesium was discontinued after 1283. Patients received postoperative pelvic radiation on the basis of the depth of invasion, extrauterine pelvic disease, and/or cervix involvement. No patient underwent a pelvic lymphadenectomy. Only palpably suspicious nodes were removed. Twenty-one of these two hundred sixteen patients developed a recurrence. These 21 cases are analyzed for the probability of a staging lymphadenectomy having prevented their recurrence. Median follow-up of all 216 patients is 61 months with a mean time to recurrence of 26.5 months. No patient was lost to follow-up. Patients who recurred are analyzed by grade, depth of invasion, surgical stage, time to recurrence, site of recurrence, survival, protocol breaks, and frozen section discrepancies. No patient recurred on the pelvic sidewall. All patients found to have positive para-aortic nodes have died. No patient who received vaginal and/or pelvic radiation recurred in the pelvis. 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Belinson M.D.</name><affiliations><json:string>Department of Obstetrics and Gynecology, University of Vermont, Burlington, Vermont 05401 USA</json:string></affiliations></json:item><json:item><name>Kenneth R. Lee M.D.</name><affiliations><json:string>Department of Biometry, University of Vermont, Burlington, Vermont 05401 USA</json:string></affiliations></json:item><json:item><name>Gary J. Badger M.S.</name><affiliations><json:string>Vermont Regional Cancer Center, University of Vermont, Burlington, Vermont 05401 USA</json:string></affiliations></json:item><json:item><name>Robert G. Pretorius M.D.</name><affiliations><json:string>Department of Obstetrics and Gynecology, University of Vermont, Burlington, Vermont 05401 USA</json:string></affiliations></json:item><json:item><name>Maureen A. 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These 21 cases are analyzed for the probability of a staging lymphadenectomy having prevented their recurrence. Median follow-up of all 216 patients is 61 months with a mean time to recurrence of 26.5 months. No patient was lost to follow-up. Patients who recurred are analyzed by grade, depth of invasion, surgical stage, time to recurrence, site of recurrence, survival, protocol breaks, and frozen section discrepancies. No patient recurred on the pelvic sidewall. All patients found to have positive para-aortic nodes have died. No patient who received vaginal and/or pelvic radiation recurred in the pelvis. 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Center, Department of Gynecology A81, Cleveland, OH 44195-5037.</affiliation><affiliation>Department of Obstetrics and Gynecology, University of Vermont, Burlington, Vermont 05401 USA</affiliation></author><author xml:id="author-0001"><persName><forename type="first">Kenneth R.</forename><surname>Lee</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Department of Biometry, University of Vermont, Burlington, Vermont 05401 USA</affiliation></author><author xml:id="author-0002"><persName><forename type="first">Gary J.</forename><surname>Badger</surname></persName><roleName type="degree">M.S.</roleName><affiliation>Vermont Regional Cancer Center, University of Vermont, Burlington, Vermont 05401 USA</affiliation></author><author xml:id="author-0003"><persName><forename type="first">Robert G.</forename><surname>Pretorius</surname></persName><roleName type="degree">M.D.</roleName><note type="biography">Current address: Kaiser Permanente Medical Center, 4647 Zion Ave., San Diego, CA 92014.</note><affiliation>Current address: Kaiser Permanente Medical Center, 4647 Zion Ave., San Diego, CA 92014.</affiliation><affiliation>Department of Obstetrics and Gynecology, University of Vermont, Burlington, Vermont 05401 USA</affiliation></author><author xml:id="author-0004"><persName><forename type="first">Maureen A.</forename><surname>Jarrell</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Department of Obstetrics and Gynecology, University of Vermont, Burlington, Vermont 05401 USA</affiliation></author><idno type="istex">8D2A9479A64170A3B1057BAAEF2D7D72030E4AD4</idno><idno type="DOI">10.1016/0090-8258(92)90005-4</idno><idno type="PII">0090-8258(92)90005-4</idno></analytic><monogr><title level="j">Gynecologic Oncology</title><title level="j" type="abbrev">YGYNO</title><idno type="pISSN">0090-8258</idno><idno type="PII">S0090-8258(00)X0199-0</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1992"></date><biblScope unit="volume">44</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="17">17</biblScope><biblScope unit="page" to="23">23</biblScope></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>1992</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Two hundred forty-eight consecutive patients with clinical Stage I adenocarcinoma of the endometrium were seen between 877 and 888. Twenty-one were medically not operable and eleven others had papillary serous tumors. The remaining 216 were managed by a consistent operative protocol except that routine preoperative cesium was discontinued after 1283. Patients received postoperative pelvic radiation on the basis of the depth of invasion, extrauterine pelvic disease, and/or cervix involvement. No patient underwent a pelvic lymphadenectomy. Only palpably suspicious nodes were removed. Twenty-one of these two hundred sixteen patients developed a recurrence. These 21 cases are analyzed for the probability of a staging lymphadenectomy having prevented their recurrence. Median follow-up of all 216 patients is 61 months with a mean time to recurrence of 26.5 months. No patient was lost to follow-up. Patients who recurred are analyzed by grade, depth of invasion, surgical stage, time to recurrence, site of recurrence, survival, protocol breaks, and frozen section discrepancies. No patient recurred on the pelvic sidewall. All patients found to have positive para-aortic nodes have died. No patient who received vaginal and/or pelvic radiation recurred in the pelvis. We conclude that staging lymphadenectomy would not have improved the outcome for these patients.</p></abstract></profileDesc><revisionDesc><change when="1992">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/8D2A9479A64170A3B1057BAAEF2D7D72030E4AD4/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Elsevier, elements deleted: tail"><istex:xmlDeclaration>version="1.0" encoding="utf-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//ES//DTD journal article DTD version 4.5.2//EN//XML" URI="art452.dtd" name="istex:docType"></istex:docType><istex:document><converted-article version="4.5.2" docsubtype="fla"><item-info><jid>YGYNO</jid><aid>92900054</aid><ce:pii>0090-8258(92)90005-4</ce:pii><ce:doi>10.1016/0090-8258(92)90005-4</ce:doi><ce:copyright type="unknown" year="1992"></ce:copyright></item-info><head><ce:dochead><ce:textfn>Regular article</ce:textfn></ce:dochead><ce:title>Clinical Stage I adenocarcinoma of the endometrium—Analysis of recurrences and the potential benefit of staging lymphadenectomy</ce:title><ce:author-group><ce:author><ce:given-name>Jerome L.</ce:given-name><ce:surname>Belinson</ce:surname><ce:degrees>M.D.</ce:degrees><ce:cross-ref refid="COR1"><ce:sup>1</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF1"><ce:sup>∗</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF2"><ce:sup>†</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Kenneth R.</ce:given-name><ce:surname>Lee</ce:surname><ce:degrees>M.D.</ce:degrees><ce:cross-ref refid="AFF3"><ce:sup>‡</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Gary J.</ce:given-name><ce:surname>Badger</ce:surname><ce:degrees>M.S.</ce:degrees><ce:cross-ref refid="AFF4"><ce:sup>§</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Robert G.</ce:given-name><ce:surname>Pretorius</ce:surname><ce:degrees>M.D.</ce:degrees><ce:cross-ref refid="AFF1"><ce:sup>∗</ce:sup></ce:cross-ref><ce:cross-ref refid="FN1"><ce:sup>2</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Maureen A.</ce:given-name><ce:surname>Jarrell</ce:surname><ce:degrees>M.D.</ce:degrees><ce:cross-ref refid="AFF1"><ce:sup>∗</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF2"><ce:sup>†</ce:sup></ce:cross-ref></ce:author><ce:affiliation id="AFF1"><ce:label>∗</ce:label><ce:textfn>Department of Obstetrics and Gynecology, University of Vermont, Burlington, Vermont 05401 USA</ce:textfn></ce:affiliation><ce:affiliation id="AFF2"><ce:label>†</ce:label><ce:textfn>Department of Pathology, University of Vermont, Burlington, Vermont 05401 USA</ce:textfn></ce:affiliation><ce:affiliation id="AFF3"><ce:label>‡</ce:label><ce:textfn>Department of Biometry, University of Vermont, Burlington, Vermont 05401 USA</ce:textfn></ce:affiliation><ce:affiliation id="AFF4"><ce:label>§</ce:label><ce:textfn>Vermont Regional Cancer Center, University of Vermont, Burlington, Vermont 05401 USA</ce:textfn></ce:affiliation><ce:correspondence id="COR1"><ce:label>1</ce:label><ce:text>To whom reprint requests should be addressed at current address: Department of Gynecology, Cleveland Clinic Foundation, One Clinic Center, Department of Gynecology A81, Cleveland, OH 44195-5037.</ce:text></ce:correspondence><ce:footnote id="FN1"><ce:label>2</ce:label><ce:note-para>Current address: Kaiser Permanente Medical Center, 4647 Zion Ave., San Diego, CA 92014.</ce:note-para></ce:footnote></ce:author-group><ce:date-received day="8" month="11" year="1990"></ce:date-received><ce:abstract><ce:section-title>Abstract</ce:section-title><ce:abstract-sec><ce:simple-para>Two hundred forty-eight consecutive patients with clinical Stage I adenocarcinoma of the endometrium were seen between <math altimg="si1.gif"><fr shape="sol"><nu>8</nu><de>77</de></fr></math> and <math altimg="si2.gif"><fr shape="sol"><nu>8</nu><de>88</de></fr></math>. Twenty-one were medically not operable and eleven others had papillary serous tumors. The remaining 216 were managed by a consistent operative protocol except that routine preoperative cesium was discontinued after <math altimg="si3.gif"><fr shape="sol"><nu>12</nu><de>83</de></fr></math>. Patients received postoperative pelvic radiation on the basis of the depth of invasion, extrauterine pelvic disease, and/or cervix involvement. No patient underwent a pelvic lymphadenectomy. Only palpably suspicious nodes were removed. Twenty-one of these two hundred sixteen patients developed a recurrence. These 21 cases are analyzed for the probability of a staging lymphadenectomy having prevented their recurrence. Median follow-up of all 216 patients is 61 months with a mean time to recurrence of 26.5 months. No patient was lost to follow-up. Patients who recurred are analyzed by grade, depth of invasion, surgical stage, time to recurrence, site of recurrence, survival, protocol breaks, and frozen section discrepancies. No patient recurred on the pelvic sidewall. All patients found to have positive para-aortic nodes have died. No patient who received vaginal and/or pelvic radiation recurred in the pelvis. We conclude that staging lymphadenectomy would not have improved the outcome for these patients.</ce:simple-para></ce:abstract-sec></ce:abstract></head></converted-article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo><title>Clinical Stage I adenocarcinoma of the endometrium—Analysis of recurrences and the potential benefit of staging lymphadenectomy</title></titleInfo><titleInfo type="alternative" contentType="CDATA"><title>Clinical Stage I adenocarcinoma of the endometrium—Analysis of recurrences and the potential benefit of staging lymphadenectomy</title></titleInfo><name type="personal"><namePart type="given">Jerome L.</namePart><namePart type="family">Belinson</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Department of Obstetrics and Gynecology, University of Vermont, Burlington, Vermont 05401 USA</affiliation><description>To whom reprint requests should be addressed at current address: Department of Gynecology, Cleveland Clinic Foundation, One Clinic Center, Department of Gynecology A81, Cleveland, OH 44195-5037.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Kenneth R.</namePart><namePart type="family">Lee</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Department of Biometry, University of Vermont, Burlington, Vermont 05401 USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Gary J.</namePart><namePart type="family">Badger</namePart><namePart type="termsOfAddress">M.S.</namePart><affiliation>Vermont Regional Cancer Center, University of Vermont, Burlington, Vermont 05401 USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Robert G.</namePart><namePart type="family">Pretorius</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Department of Obstetrics and Gynecology, University of Vermont, Burlington, Vermont 05401 USA</affiliation><description>Current address: Kaiser Permanente Medical Center, 4647 Zion Ave., San Diego, CA 92014.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Maureen A.</namePart><namePart type="family">Jarrell</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Department of Obstetrics and Gynecology, University of Vermont, Burlington, Vermont 05401 USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="Full-length article"></genre><originInfo><publisher>ELSEVIER</publisher><dateIssued encoding="w3cdtf">1992</dateIssued><copyrightDate encoding="w3cdtf">1992</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract lang="en">Two hundred forty-eight consecutive patients with clinical Stage I adenocarcinoma of the endometrium were seen between 877 and 888. Twenty-one were medically not operable and eleven others had papillary serous tumors. The remaining 216 were managed by a consistent operative protocol except that routine preoperative cesium was discontinued after 1283. Patients received postoperative pelvic radiation on the basis of the depth of invasion, extrauterine pelvic disease, and/or cervix involvement. No patient underwent a pelvic lymphadenectomy. Only palpably suspicious nodes were removed. Twenty-one of these two hundred sixteen patients developed a recurrence. These 21 cases are analyzed for the probability of a staging lymphadenectomy having prevented their recurrence. Median follow-up of all 216 patients is 61 months with a mean time to recurrence of 26.5 months. No patient was lost to follow-up. Patients who recurred are analyzed by grade, depth of invasion, surgical stage, time to recurrence, site of recurrence, survival, protocol breaks, and frozen section discrepancies. No patient recurred on the pelvic sidewall. All patients found to have positive para-aortic nodes have died. No patient who received vaginal and/or pelvic radiation recurred in the pelvis. We conclude that staging lymphadenectomy would not have improved the outcome for these patients.</abstract><note type="content">Section title: Regular article</note><relatedItem type="host"><titleInfo><title>Gynecologic Oncology</title></titleInfo><titleInfo type="abbreviated"><title>YGYNO</title></titleInfo><genre type="journal">journal</genre><originInfo><dateIssued encoding="w3cdtf">199201</dateIssued></originInfo><identifier type="ISSN">0090-8258</identifier><identifier type="PII">S0090-8258(00)X0199-0</identifier><part><date>199201</date><detail type="volume"><number>44</number><caption>vol.</caption></detail><detail type="issue"><number>1</number><caption>no.</caption></detail><extent unit="issue pages"><start>1</start><end>119</end></extent><extent unit="pages"><start>17</start><end>23</end></extent></part></relatedItem><identifier type="istex">8D2A9479A64170A3B1057BAAEF2D7D72030E4AD4</identifier><identifier type="DOI">10.1016/0090-8258(92)90005-4</identifier><identifier type="PII">0090-8258(92)90005-4</identifier><recordInfo><recordContentSource>ELSEVIER</recordContentSource></recordInfo></mods></metadata></istex></record>Pour manipuler ce document sous Unix (Dilib)
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