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- 저자 : Emmanuelle Arsène (검색결과 1 건)
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Emmanuelle Arsène,Géraldine Bleu,Benjamin Merlot,Loïc Boulanger,Denis Vinatier,Olivier Kerdraon,Pierre Collinet 대한부인종양학회 2015 Journal of Gynecologic Oncology Vol.26 No.2
Objective: Since European Society for Medical Oncology (ESMO) recommendations and French guidelines, pelvic lymphadenectomyshould not be systematically performed for women with early-stage endometrioid endometrial cancer (EEC) preoperativelyassessed at presumed low- or intermediate-risk. The aim of our study was to evaluate the change of our surgical practices afterESMO recommendations, and to evaluate the rate and morbidity of second surgical procedure in case of understaging after thefirst surgery. Methods: This retrospective single-center study included women with EEC preoperatively assessed at presumed low- orintermediate-risk who had surgery between 2006 and 2013. Two periods were defined the times before and after ESMOrecommendations. Demographics characteristics, surgical management, operative morbidity, and rate of understaging werecompared. The rate of second surgical procedure required for lymph node resection during the second period and its morbiditywere also studied. Results: Sixty-one and sixty-two patients were operated for EEC preoperatively assessed at presumed low-or intermediate-riskbefore and after ESMO recommendations, respectively. Although immediate pelvic lymphadenectomy was performed morefrequently during the first period than the second period (88.5% vs. 19.4%; p<0.001), the rate of postoperative risk-elevating orupstaging were comparable between the two periods (31.1% vs. 27.4%; p=0.71). Among the patients requiring second surgicalprocedure during the second period (21.0%), 30.8% did not undergo the second surgery due to their comorbidity or old age. For the patients who underwent second surgical procedure, mean operative time of the second procedure was 246.1±117.8minutes. Third operation was required in 33.3% of them because of postoperative complications. Conclusion: Since ESMO recommendations, second surgical procedure for lymph node resection is often required for womenwith EEC presumed at low- or intermediate-risk. This reoperation is not always performed due to age/comorbidity of thepatients, and presents a significant morbidity.
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