Cancer 1987-10-15
Surgical pathologic spread patterns of endometrial cancer. A Gynecologic Oncology Group Study.
Abstract
The surgical pathologic features of 621 patients with Stage I carcinoma of the endometrium are presented. All patients were treated with primary surgery consisting of total abdominal hysterectomy, bilateral salpingo-oophorectomy, selective pelvic and paraaortic lymphadenectomy and peritoneal cytology. An appreciable number of patients (144-22%) with Stage I cancers have disease outside of the uterus (lymph node metastasis, adnexal disease, intraperitoneal spread and/or malignant cells in peritoneal washings). Multiple prognostic factors particularly grade and depth of invasion are related to extrauterine disease. This study adds credence to the primary surgical approach with individualized postoperative therapy as indicated.
Related Questions
What is your preferred surgical management of an endometrial cancer with clinically apparent extension to the cervix?
Given in this scenario with clinically apparent cervical extension and an MRI negative for parametrial involvement, I would want to also ensure the nodes appear normal making the disease consistent with FIGO stage II disease. In this scenario, if the patient does clinically have disease limited to t...
Would you recommend adjuvant therapy for a non-invasive Grade 3 endometrioid endometrial cancer that is P53 wild-type and MMR deficient (due to methylation)?
I would not give adjuvant therapy. The risk of nodal met is low based on GOG 33 and all other known data. Given that the tumor is p53 negative, I am going to assume it will not behave as a serous tumor.So, would observe.
Would you change your approach to adjuvant radiation for an incompletely staged, at least IB, grade 1 endometrial cancer, if a uterine perforation occurred at time of surgery?
Similarly to the above authors, I agree with offering this patient vaginal brachytherapy. Though she does not definitively meet GOG99 criteria, given the situation with deep myometrial invasion and perforation, this is a reasonable and low-risk treatment opportunity to decrease local recurrence. The...
How would you manage a patient with low-volume non-invasive endometrioid carcinoma that is found in both the endometrium and ovary (pN0)?
Isolated ovarian involvement in endometrial cancer is uncommon, and previous data from the Gynecologic Oncology Group and other single-institution series suggest that it occurs in less than 5% of patients. (Creasman et al. Cancer, 1987; Lin et al. Gynecol Oncol, 2015) Adnexal involvement when presen...