The Role of Lymphadenectomy in Surgical Staging of Endometrial Cancer
Identifieur interne : 004A68 ( Ncbi/Merge ); précédent : 004A67; suivant : 004A69The Role of Lymphadenectomy in Surgical Staging of Endometrial Cancer
Auteurs : Nikki L. Neubauer [États-Unis] ; John R. LurainSource :
- International Journal of Surgical Oncology [ 2090-1402 ] ; 2011.
Abstract
Surgical staging, including lymph node sampling, for endometrial cancer was adopted by the International Federation of Gynecology and Obstetrics (FIGO) in 1988 based on reports demonstrating diagnostic and therapeutic advantages. This review focuses on the incidence of lymph node metastasis, risk factors for lymph node involvement, the effect of lymph node metastasis on prognosis, the therapeutic effect and diagnostic usefulness of lymphadenectomy, risks of lymph node dissection, and future directions in surgical staging of endometrial cancer. Surgical staging identifies most patients with extrauterine disease as well as uterine risk factors for recurrence, thereby allowing for a more informed approach to postoperative adjuvant therapy. Lymphadenectomy as a part of surgical staging is not required in patients assessed intraoperatively to be at low risk for lymph node metastasis (<2 cm grade 1 tumors with superficial myometrial invasion), however, a systematic lymph node dissection should be performed in most other patients with endometrial cancer. In the future, molecular markers may be useful to predict preoperatively tumor aggressiveness and lymph node metastasis. It is hoped that an approach of surgical staging with selective lymph node dissection will improve survival and spare patients additional surgical complications or unnecessary postoperative exposure to radiation and/or chemotherapy.
Url:
DOI: 10.1155/2011/814649
PubMed: 22312525
PubMed Central: 3263657
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">The Role of Lymphadenectomy in Surgical Staging of Endometrial Cancer</title><author><name sortKey="Neubauer, Nikki L" sort="Neubauer, Nikki L" uniqKey="Neubauer N" first="Nikki L." last="Neubauer">Nikki L. Neubauer</name><affiliation wicri:level="1"><nlm:aff id="I1">Division of Gynecologic Oncology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Gynecologic Oncology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL</wicri:regionArea><wicri:noRegion>IL</wicri:noRegion></affiliation></author><author><name sortKey="Lurain, John R" sort="Lurain, John R" uniqKey="Lurain J" first="John R." last="Lurain">John R. Lurain</name><affiliation><nlm:aff>NONE</nlm:aff></affiliation><affiliation><nlm:aff>NONE</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">22312525</idno><idno type="pmc">3263657</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3263657</idno><idno type="RBID">PMC:3263657</idno><idno type="doi">10.1155/2011/814649</idno><date when="2011">2011</date><idno type="wicri:Area/Pmc/Corpus">004A81</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">004A81</idno><idno type="wicri:Area/Pmc/Curation">004A80</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">004A80</idno><idno type="wicri:Area/Pmc/Checkpoint">002C88</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">002C88</idno><idno type="wicri:Area/Ncbi/Merge">004A68</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">The Role of Lymphadenectomy in Surgical Staging of Endometrial Cancer</title><author><name sortKey="Neubauer, Nikki L" sort="Neubauer, Nikki L" uniqKey="Neubauer N" first="Nikki L." last="Neubauer">Nikki L. Neubauer</name><affiliation wicri:level="1"><nlm:aff id="I1">Division of Gynecologic Oncology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Gynecologic Oncology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL</wicri:regionArea><wicri:noRegion>IL</wicri:noRegion></affiliation></author><author><name sortKey="Lurain, John R" sort="Lurain, John R" uniqKey="Lurain J" first="John R." last="Lurain">John R. Lurain</name><affiliation><nlm:aff>NONE</nlm:aff></affiliation><affiliation><nlm:aff>NONE</nlm:aff></affiliation></author></analytic><series><title level="j">International Journal of Surgical Oncology</title><idno type="ISSN">2090-1402</idno><idno type="eISSN">2090-1410</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Surgical staging, including lymph node sampling, for endometrial cancer was adopted by the
International Federation of Gynecology and Obstetrics (FIGO) in 1988 based on reports demonstrating
diagnostic and therapeutic advantages. This review focuses on the incidence of lymph node metastasis,
risk factors for lymph node involvement, the effect of lymph node metastasis on prognosis, the
therapeutic effect and diagnostic usefulness of lymphadenectomy, risks of lymph node dissection, and
future directions in surgical staging of endometrial cancer. Surgical staging identifies most patients with
extrauterine disease as well as uterine risk factors for recurrence, thereby allowing for a more informed
approach to postoperative adjuvant therapy. Lymphadenectomy as a part of surgical staging is not
required in patients assessed intraoperatively to be at low risk for lymph node metastasis (<2 cm grade
1 tumors with superficial myometrial invasion), however, a systematic lymph node dissection should be
performed in most other patients with endometrial cancer. In the future, molecular markers may be
useful to predict preoperatively tumor aggressiveness and lymph node metastasis. It is hoped that an
approach of surgical staging with selective lymph node dissection will improve survival and spare
patients additional surgical complications or unnecessary postoperative exposure to radiation and/or
chemotherapy.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Creasman, Wt" uniqKey="Creasman W">WT Creasman</name></author><author><name sortKey="Morrow, Cp" uniqKey="Morrow C">CP Morrow</name></author><author><name sortKey="Bundy, Bn" uniqKey="Bundy B">BN Bundy</name></author><author><name sortKey="Homesley, Hd" uniqKey="Homesley H">HD Homesley</name></author><author><name sortKey="Graham, Je" uniqKey="Graham J">JE Graham</name></author><author><name sortKey="Heller, Pb" uniqKey="Heller P">PB Heller</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Kilgore, Lc" uniqKey="Kilgore L">LC Kilgore</name></author><author><name sortKey="Partridge, Ee" uniqKey="Partridge E">EE Partridge</name></author><author><name sortKey="Alvarez, Rd" uniqKey="Alvarez R">RD Alvarez</name></author></analytic></biblStruct><biblStruct><analytic><author><name 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Int J Surg Oncol</journal-id><journal-id journal-id-type="iso-abbrev">Int J Surg Oncol</journal-id><journal-id journal-id-type="publisher-id">IJSO</journal-id><journal-title-group><journal-title>International Journal of Surgical Oncology</journal-title></journal-title-group><issn pub-type="ppub">2090-1402</issn><issn pub-type="epub">2090-1410</issn><publisher><publisher-name>Hindawi Publishing Corporation</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">22312525</article-id><article-id pub-id-type="pmc">3263657</article-id><article-id pub-id-type="doi">10.1155/2011/814649</article-id><article-categories><subj-group subj-group-type="heading"><subject>Review Article</subject></subj-group></article-categories><title-group><article-title>The Role of Lymphadenectomy in Surgical Staging of Endometrial Cancer</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Neubauer</surname><given-names>Nikki L.</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Lurain</surname><given-names>John R.</given-names></name><xref ref-type="aff" rid="I1"><sup>1, 2</sup></xref><xref ref-type="aff" rid="I2"></xref><xref ref-type="corresp" rid="cor1">*</xref></contrib></contrib-group><aff id="I1"><sup>1</sup>Division of Gynecologic Oncology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA</aff><aff id="I2"><sup>2</sup>Prentice Women's Hospital, 250 E. Superior St., Suite 05-2168, Chicago, IL 60611, USA</aff><author-notes><corresp id="cor1">*John R. Lurain: <email>jlurain@nmff.org</email></corresp><fn fn-type="other"><p>Academic Editor: Perry Shen</p></fn></author-notes><pub-date pub-type="ppub"><year>2011</year></pub-date><pub-date pub-type="epub"><day>10</day><month>7</month><year>2011</year></pub-date><volume>2011</volume><elocation-id>814649</elocation-id><history><date date-type="received"><day>15</day><month>1</month><year>2011</year></date><date date-type="rev-recd"><day>26</day><month>4</month><year>2011</year></date><date date-type="accepted"><day>30</day><month>4</month><year>2011</year></date></history><permissions><copyright-statement>Copyright © 2011 N. L. Neubauer and J. R. Lurain.</copyright-statement><copyright-year>2011</copyright-year><license xlink:href="https://creativecommons.org/licenses/by/3.0/"><license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><p>Surgical staging, including lymph node sampling, for endometrial cancer was adopted by the
International Federation of Gynecology and Obstetrics (FIGO) in 1988 based on reports demonstrating
diagnostic and therapeutic advantages. This review focuses on the incidence of lymph node metastasis,
risk factors for lymph node involvement, the effect of lymph node metastasis on prognosis, the
therapeutic effect and diagnostic usefulness of lymphadenectomy, risks of lymph node dissection, and
future directions in surgical staging of endometrial cancer. Surgical staging identifies most patients with
extrauterine disease as well as uterine risk factors for recurrence, thereby allowing for a more informed
approach to postoperative adjuvant therapy. Lymphadenectomy as a part of surgical staging is not
required in patients assessed intraoperatively to be at low risk for lymph node metastasis (<2 cm grade
1 tumors with superficial myometrial invasion), however, a systematic lymph node dissection should be
performed in most other patients with endometrial cancer. In the future, molecular markers may be
useful to predict preoperatively tumor aggressiveness and lymph node metastasis. It is hoped that an
approach of surgical staging with selective lymph node dissection will improve survival and spare
patients additional surgical complications or unnecessary postoperative exposure to radiation and/or
chemotherapy.</p></abstract></article-meta></front></pmc><affiliations><list><country><li>États-Unis</li></country></list><tree><noCountry><name sortKey="Lurain, John R" sort="Lurain, John R" uniqKey="Lurain J" first="John R." last="Lurain">John R. Lurain</name></noCountry><country name="États-Unis"><noRegion><name sortKey="Neubauer, Nikki L" sort="Neubauer, Nikki L" uniqKey="Neubauer N" first="Nikki L." last="Neubauer">Nikki L. Neubauer</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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