Symposium on advances in endometrial cancer epidemiology and biology

Endometrial cancer (EC) is the most common gynecological neoplasm in developed countries.In literature, there are discordant data regarding the therapeutic value of systematic lymphadenectomy whereas the importance of lymph node status for determining prognosis and the need for adjuvant treatment is undoubted. Given the low risk of lymph-node metastases in the apparent early-stage disease and the significant surgical and postoperative risks when performing a complete pelvic lymphadenectomy, the surgical approach in these patients is controversial, ranging from no nodal evaluation to comprehensive pelvic and aortic lymphadenectomy. The recent introduction of sentinel node mapping represents the mid-way between the execution and omission of node dissection in EC patients. Indeed, the sentinel node mapping has rapidly emerged as an alternative to complete lymphadenectomy to reduce morbidity. In the present review, we discuss the role of sentinel node mapping in the surgical management of EC evaluating all aspects of this procedure.

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“…EC is a common gynecologic malignancy with an increasing incidence and an age of onset younger than in prior years ( 1 , 2 ).…”

Section: Introductionmentioning

confidence: 99%

Sentinel lymph node biopsy in endometrial cancer: state of the art

Corte¹,

Giampaolino²,

Mercorio³

et al. 2020

Transl Cancer Res TCR

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“…There is a limitation to the current study. Timely surgical treatment is the most important factor influencing the early-stage EEC prognosis ( 36 – 39 ). However, all patients received radical operation in the study.…”

Section: Discussionmentioning

confidence: 99%

Prognostic-Related Metabolic Score for Survival Prediction in Early-Stage Endometrioid Endometrial Cancer: A Multi-Center and Retrospective Study

et al. 2022

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ObjectivePatients with endometrial cancer (EC) combined with metabolic syndrome (MetS) have a worse prognosis than those without MetS. This study aimed to investigate whether partial metabolic disorder significantly influenced early-stage endometrioid EC (EEC) survival and searched for a more efficient method to evaluate metabolic status.MethodsThis is a nationwide, multicenter cohort study that included 998 patients with primary early-stage EEC from 2001 to 2018. Patients were divided into different metabolic groups based on the diagnostic criteria of the Chinese Medical Association (CDC). The progression-free survival (PFS) time was compared between various metabolic status. Meanwhile, we established an EC Prognostic-Related Metabolic Score (ECPRM Score) to explore the association of the severity of metabolic status and early-stage EEC PFS. A nomogram was established for predicting PFS, which was externally validated in a testing set that includes 296 patients.ResultsA partial metabolic disorder, as well as MetS, was an independent risk factor of poor survival of patients with early-stage EEC [hazard ratio (HR) = 7.6, 95% CI = 1.01–57.5, p < 0.05]. A high ECPRM Score was associated with lower PFS (HR = 2.1, 95% CI = 1.05–4.0, p < 0.001). The nomogram, in which the ECPRM Score contributed most to the prognosis, exhibited excellent discrimination of survival supported by the internal and external validations. In addition, the calibration curve supports its robust predicting ability.ConclusionEven though they do not meet the criteria of MetS, partial metabolic disorders were also associated with adverse outcomes in early-stage EEC. The ECPRM Score is beneficial for clinicians to evaluate the severity of metabolic abnormalities and guide patients to ameliorate the poor prognosis of metabolic disorders.

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“…Gynecologic cancers are common among older women. Almost 50% of ovarian cancer (OC) cases are in women aged >65 years, and endometrial cancer (EC) is diagnosed in older women with a mean age at diagnosis of 68 years [ 3 , 4 ]. Cervical cancer (CC) accounts for a quarter of the cases occurring after the age of 65 years [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Surgical Treatment Outcomes of Gynecologic Cancer in Older Patients: A Retrospective Study

Shim

Kim

2023

JCM

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This study aimed to evaluate oncologic characteristics and surgical outcomes in older patients with gynecologic cancers. This retrospective study included patients aged ≥65 years who were diagnosed with gynecologic cancers and underwent surgical treatment between 2005 and 2020. We reviewed the medical records for age at diagnosis, body mass index, American Society of Anesthesiologists score, comorbidities, postoperative complications, cancer stage, histologic type, surgical treatment, postoperative outcome, and survival rate. Data were compared between groups according to the age at the time of diagnosis: <75 years (young-old) and ≥75 years (old-old). In total, 131 patients were identified: 53 (40.5%) with ovarian or primary peritoneal cancer (OC), 44 (33.6%) with endometrial cancer (EC), 30 (22.9%) with cervical cancer, and 4 (3.1%) with leiomyosarcoma. The patients’ mean age was 70 (range, 65–83) years; 106 (80.9%) were young-old and 25 (19.1%) were old-old. Postoperative complications occurred in 19 (14.5%) patients. Four patients died within six months after surgery, and three died because of disease progression. There was no difference in the survival rates between the two groups among those with OC and EC. Older patients with gynecologic cancers showed good surgical outcomes and tolerable postoperative complications. Therefore, we can safely offer surgical treatment to older patients.

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Symposium on advances in endometrial cancer epidemiology and biology

Cited by 7 publications

References 34 publications

Sentinel lymph node biopsy in endometrial cancer: state of the art

Sentinel lymph node biopsy in endometrial cancer: state of the art

Prognostic-Related Metabolic Score for Survival Prediction in Early-Stage Endometrioid Endometrial Cancer: A Multi-Center and Retrospective Study

Surgical Treatment Outcomes of Gynecologic Cancer in Older Patients: A Retrospective Study

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