China
Africa
Explore chapters and articles related to this topic
Sentinel lymph node biopsy of the endometrium
Published in Charles F. Levenback, Ate G.J. van der Zee, Robert L. Coleman, Clinical Lymphatic Mapping in Gynecologic Cancers, 2022
Jennifer J. Mueller, Nadeem R. Abu-Rustum
Lymphadenectomy is associated with increased perioperative risk, including bleeding, operative injury, lymphocele development, and chronic leg lymphedema, which can have a dramatic impact on quality of life. Prospective trials conducted in patients with apparent early-stage endometrial cancer undergoing comprehensive nodal staging demonstrated that nodal evaluation is prognostic but not associated with a survival advantage,12,13 providing the impetus for the exploration of SLN techniques in endometrial cancer. SLN mapping is associated with decreased morbidity and increased precision in detecting nodal disease and provides valuable prognostic information. Leitao et al. used a mailed survey to describe the first patient-reported outcomes on postoperative leg lymphedema in surgically staged patients with endome-trial cancer, with encouraging results in support of SLN versus lymphadenectomy.16
Cervical Cancer Screening And Management In Pregnancy
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
Vaidehi Mujumdar, Scott D. Richard
Given the technical complications performing lymphadenectomy after 25 weeks of gestation, in patients diagnosed after 25 weeks, it is recommended to delay treatment and full surgical staging until after delivery. If disease progression is suspected, it is recommended to obtain an abdominal and pelvic MRI [21].
Mid Common Bile Duct Cholangiocarcinoma Involving the Portal Vein and Right Branch of the Hepatic Artery
Published in Savio George Barreto, Shailesh V. Shrikhande, Dilemmas in Abdominal Surgery, 2020
Charles W. Kimbrough, Timothy M. Pawlik
A 58-year-old man presented to his primary physician with vague abdominal pain and new onset jaundice. Laboratory evaluation was remarkable for an elevation of the total bilirubin. Cross-sectional imaging showed both intrahepatic and extrahepatic biliary ductal dilation with a proximal common bile duct mass extending cephalad toward the hepatic hilum. The mass appeared to involve the main portal vein and right hepatic artery (Figure 30.1). Brushings obtained from endoscopic retrograde cholangiopancreatography confirmed adenocarcinoma. The patient was diagnosed with an extrahepatic cholangiocarcinoma and offered an extended right hepatectomy. On exploration, the tumor was noted to invade the main portal vein and required vein resection with primary reanastomosis. The right hepatic artery was divided close to the bifurcation and taken en bloc with the specimen. A lymphadenectomy was also performed. Pathology confirmed a 2.8 cm, moderately differentiated adenocarcinoma with local invasion into the portal vein and right hepatic artery; three out of six nodes had the presence of metastatic disease.
Evaluating the impact of the COVID-19 pandemic on tertiary gynaecological cancer care delivery: a population based study
Published in Journal of Obstetrics and Gynaecology, 2022
Jack Lowe-Zinola, Megan Williamson, Ellen Gaunt, Holly Boulter, Rachel Pounds, Sean Kehoe, Jason Yap
Central pathology review is usually undertaken for all patients with cervical cancer but this was not the case for one patient diagnosed with squamous cell carcinoma of the cervix, FIGO stage 1B1 (Bhatla 2018) based on clinical assessment and cross-sectional imaging. She underwent radical hysterectomy with pelvic lymphadenectomy and the final specimen histopathology confirmed FIGO stage 1B1 disease. Another patient’s decision was altered in recommending hysterectomy without pelvic lymphadenectomy for her provisional FIGO stage 2 endometrioid endometrial carcinoma. Our centre would usually advocate lymphadenectomy in this patient for the diagnostic purposes of aiding decisions on adjuvant radiotherapy (de Boer et al. 2018). In this case, the pathway was changed to reduce operative morbidity, allowing the procedure to proceed whilst resources were limited. The patient was ultimately able to undergo hysterectomy with pelvic lymphadenectomy because resources were available by the time she had surgery. The final surgical staging was FIGO stage 2, and the patient was offered adjuvant vaginal vault brachytherapy.
Predictability of lymph node involvement in uterus-confined endometrioid endometrial cancer by tumour size, pattern and location measured with transvaginal ultrasonography: can we save time?
Published in Journal of Obstetrics and Gynaecology, 2022
Ghanim Khatib, Mehmet Ali Vardar, Ahmet Barış Güzel, Ümran Küçükgöz Güleç, Sevgül Köse, Sevtap Seyfettinoğlu, Mete Sucu, Derya Gümürdülü
Lymphatic dissemination is the main metastatic route for endometrial carcinoma. For majority of the cases, pelvic nodes are noted to be the primary targets (Koskas et al. 2015). Lymph node involvement is one of the most significant prognostic factors (Berretta et al. 2014; Koskas et al. 2015; Li et al. 2019). Surgical staging of the endometrial carcinoma has been considered to be the substantial treatment since the International Federation of Gynecology and Obstetrics (FIGO) staging system was put forward in 1988 (Koskas et al. 2015; Li et al. 2019). According to FIGO, total hysterectomy, bilateral salpingo-oophorectomy with pelvic and para-aortic lymphadenectomy are the standard procedures for endometrial cancer staging surgery (Frost et al. 2017; Li et al. 2019). Lymphadenectomy provides notable information concerning the stage and prognosis. Thus, more precise adjuvant treatments’ decision can be made. However, its therapeutic benefit was not verified by the randomised prospective trials (Panici et al. 2008; ASTEC Study Group 2009; Frost et al. 2017).
Survival Advantage of Lymphadenectomy in Patients with Ovarian Cancer
Published in Cancer Investigation, 2022
Atanas Ignatov, Sheref Salim Hassan, Stylianos Ivros, Thomas Papathemelis, Zoya Ignatova, Holm Eggemann
The strengths of our study are: (i) large cohort size and follow-up; (ii) assessment of patients’ co-morbidity and performance status; (iii) high level of external validation, as lymphadenectomy was investigated under real clinical conditions (e.g. multi-centric, the structure of the study population resembled that of the general population); (iv) minimal loss of follow-up regarding OS; and (v) systematically performed lymphadenectomy in a standardised manner with an adequate number of removed and metastatic lymph nodes, excluding performance bias. The retrospective character and missing evaluation of the quality of surgery represent a limitation of our study. Our results describe no correlation between performance of lymphadenectomy and patients’ survival, once adjusted for confounding factors.