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Stefano Uccella,Francesca Falcone,Stefano Greggi,Francesco Fanfani,Pierandrea De Iaco,Giacomo Corrado,Marcello Ceccaroni,Vincenzo Dario Mandato,Stefano Bogliolo,Jvan Casarin,Giorgia Monterossi,Ciro Pi 대한부인종양학회 2018 Journal of Gynecologic Oncology Vol.29 No.6
Objective: To investigate survival outcomes in endometrioid endometrial cancer (EEC) patients with single vs. multiple positive pelvic lymph nodes. Methods: We performed a retrospective evaluation of all consecutive patients with histologically proven International Federation of Gynecology and Obstetrics (FIGO) stage IIIC1 EEC who underwent primary surgical treatment between 2004 and 2014 at seven Italian gynecologic oncology referral centers. Patients with pre- or intra-operative evidence of extra-uterine disease (including the presence of bulky nodes) and patients with stage IIIC2 disease were excluded, in order to obtain a homogeneous population. Results: Overall 140 patients met the inclusion criteria. The presence of >1 metastatic pelvic node was significantly associated with an increased risk of recurrence and mortality, compared to only 1 metastatic node, at both univariate (recurrence: hazard ratio [HR]=2.19; 95% confidence interval [CI]=1.2–3.99; p=0.01; mortality: HR=2.8; 95% CI=1.24–6.29; p=0.01) and multivariable analysis (recurrence: HR=1.91; 95% CI=1.02–3.56; p=0.04; mortality: HR=2.62; 95% CI=1.13–6.05; p=0.02) and it was the only independent predictor of prognosis in this subset of patients. Disease-free survival (DFS) and disease-specific survival (DSS) were significantly longer in patients with only 1 metastatic node compared to those with more than 1 metastatic node (p=0.008 and 0.009, respectively). Conclusion: The presence of multiple metastatic nodes in stage IIIC1 EEC represents an independent predictor of worse survival, compared to only one positive node. Our data suggest that EEC patients may be categorized according to the number of positive nodes.
Emanuele Perrone,Ilaria Capasso,Tina Pasciuto,Alessandro Gioè,Salvatore Gueli Alletti,Stefano Restaino,Giovanni Scambia,Francesco Fanfani 대한부인종양학회 2021 Journal of Gynecologic Oncology Vol.32 No.3
Objective: The aim of this study is to analyze and draw the potential differences between therobotic-assisted surgery (RS) and the laparoscopy (LPS) in endometrial cancer staging. Methods: In this single-institution retrospective study we enrolled 1,221 consecutive clinicalstage I–III endometrial cancer patients undergone minimally invasive surgical staging. Wecompared patients treated by LPS and by RS, on the basis of perioperative and oncologicaloutcomes (disease-free survival [DFS] and overall survival [OS]). A sub-analysis of the high risk endometrial cancer population was performed in the 2 cohorts. Results: The 2 cohorts (766 treated by LPS and 455 by RS) were homogeneous in termsof perioperative and pathological data. We recorded differences in number of relapse/progression (11.7% in LPS vs. 7% in RS, p=0.008) and in number of deaths (9.8% in LPSvs. 4.8% in RS, p=0.002). Whereas, univariate and multivariate analyses according to DFSand OS confirmed that the surgical approach did not influence the DFS or the OS. In themultivariable analysis the association of the age and grading was significant for DFS and OS. In the sub-analysis of the 426 high risk EC patients (280 in LPS and 146 in RS) the univariateand the multivariate confirmed the influence of the age in DFS and OS, independently of theminimally invasive approach. Conclusions: In our large retrospective analysis, we confirmed that the RS and LPS havesimilar efficacy and safety for endometrial cancer staging also for the high-risk endometrialcancer patients.