Radical hysterectomy plus radiotherapy or concurrent chemoradiotherapy and/or adjuvant chemotherapy could be an alternative treatment option for bulky pT2b cervical adenocarcinoma with a radio-unfavorable nature.
Objective: Laparoscopic surgery has been performed in many facilities in Japan since 2014. The aim of this study was to evaluate the selection criteria of these cases for the treatment of endometrial cancer in our hospital, as well as to assess the complications and results of postoperative pathological diagnosis. Methods: Fifty-four patients diagnosed with stage IA endometrioid carcinoma (G1-G2) with a small tumor diameter during preoperative evaluation underwent laparoscopic surgery in our hospital between 2014 and 2018. Operation time, bleeding volume, number of lymph nodes removed, complications, and postoperative pathological diagnosis were evaluated retrospectively. Results: The median patient age was 56.5 years (range: 22-79 years), and the average BMI was 21.9 (range: 16.9-32.7). The median operation time was 217 minutes (range: 145-285 minutes), and the average volume of bleeding was 20 mL (range: 0-300 mL). The average number of lymph nodes removed was 17 (range: 1-42 lymph nodes). Postoperative complications were observed in 3 cases: a port site hernia, ileal and vaginal lymphatic leakage, and lymphocyst infection. A higher pathological grading occurred in 4 out of 54 cases following postoperative pathological assessment. No stage IVB cases were reported postoperatively.
Cervical SMCC should be diagnosed rapidly and patients should undergo adequate treatment immediately. Although cervical SMCC tumors show characteristic findings on cytology, immunocytochemistry might be useful for differential diagnosis.
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