Comparison of three surgical approaches for staging lymphadenectomy in high‐risk endometrial cancer

Abstract

All three techniques demonstrated adequate staging of high-risk endometrial carcinoma. Based on improved peri-operative outcomes, the use of minimally-invasive techniques is advocated where appropriate.

Prognostic value of metabolic tumor volume and total lesion glycolysis from 18F-FDG PET/CT in lymph node metastases and risk stratification of endometrial carcinoma

“…LNM was an important prognostic factor of EC. The prognosis of EC patients with LNM was significantly lower than that of patients without LNM [69]. Surgery is considered most important and effective for treatment of primary EC, but there is still a great deal of controversy about indication and necessity of pelvic lymph node dissection [6926].…”

“…The prognosis of EC patients with LNM was significantly lower than that of patients without LNM [69]. Surgery is considered most important and effective for treatment of primary EC, but there is still a great deal of controversy about indication and necessity of pelvic lymph node dissection [6926]. Clinicians did not support lymphadenectomy for low-risk group EC patients based on low probability of LNMs in low-risk group of patients [1316], because only 5% metastases in low-risk patients with EC [27].…”

“…Another reason is that performance of iliac lymphadenectomy is not easy and often associated with post- surgical complication due to complex anatomical structure in this region [1013]. It is important to accurately detect and predict the LNM of EC for surgical planning of pelvic lymph node dissection in clinical management of EC patients [9].…”

“…The survival rate would be lower if the EC patients had pelvic or para-aortic lymph node metastases (LNMs) [4678]. The LNM of EC is one of key elements for EC classified as high-risk group, according to the International Federation of Gynecology and Obstetrics (FIGO) stage and standard of EC stratification [469]. The patients of high-risk group have a higher rate of recurrence and LNM [48].…”

Essential surgical skills for a gynecologic oncologist

“…15 When compared with open surgery, minimally invasive surgery did not compromise on nodal count or detection of nodal metastatic disease, but was associated with significantly lower blood loss and hospital stay. 25 A lack of training in laparoscopic pelvic lymph node dissection is likely to negate the benefits of training in laparoscopic hysterectomy in two ways: either the operating team is likely to convert the surgery from laparoscopic to open to complete the procedure, or there may be a temptation to omit lymph node dissection in cases where it would have been reasonably indicated. Either scenario has the potential to compromise patient outcomes.…”