AI Summary & Key Takeaways
AI InsightSystemic adjuvant therapy may be involved in the first-line treatment plan in order to prevent distant failures, since they continue to be responsible for the most of the recurrences and mortality despite radical surgeries and different protocols of adjuvant radiotherapy
📌 3 Key Takeaways
Abstract
Management of stage II endometrial cancer still has many controversies. We evaluated patients with stage II (FIGO 1988) endometrial cancer operated in our clinic in terms of treatment modalities, surgico-pathological factors, recurrence rates and patterns. Fifty-three patients with 1988 FIGO stage II endometrial cancer who underwent staging surgery between January 1993 and December 2012 were included in this study. The mean age of the patients was 57 years. Cervical invasion couldnt be detected in the preoperative pelvic examination in 47 patients (88.7%). Thirty-eight patients received simple hysterectomy (SH) and 15 patients had radical hysterectomy (RH). All patients received pelvic and paraaortic lymphadenectomy. Forty-two patients took adjuvant radiotherapy. The median follow-up time of the patient population was 39 months (range 1-139 months). Recurrence was observed in four patients. There was no statistically significant difference between the RH and SH groups in terms of recurrence (p= 0.53). Advanced age, deep myometrial invasion and the lower number of harvested lymph nodes were associated with recurrence. Systemic adjuvant therapy may be involved in the first-line treatment plan in order to prevent distant failures, since they continue to be responsible for the most of the recurrences and mortality despite radical surgeries and different protocols of adjuvant radiotherapy
Özet
Evre II endometriyum kanserinin yönetimi hala tartışmalıdır. Kliniğimizde opere olan evre II endometriyum kanseri olan hastaları tedavi çeşitleri, cerrahi-patolojik faktörler, rekürrens şekli ve sıklığı açısından değerlendirdik. Çalışmaya Ocak 1993 ve Ekim 2012 tarihleri arasında evreleme cerrahisi geçiren evre II endometriyum kanseri olan 53 hasta dahil edildi. Hastaların ortalama yaşı 57 idi. Servikal invazyon 47 hastanın (%88.7) preoperatif incelemesinde saptanamadı. Otuz-sekiz hastaya basit histerektomi (BH) ve 15 hastaya radikal histerektomi (RH) yapıldı. Tüm hastalara pelvik ve paraaortik lenfadenektomi yapıldı. Kırk-iki hasta adjuvan radyoterapi aldı. Hastaların ortalama takip süresi 39 aydı (aralık, 1-139). Rekürrens 4 hastada gelişti. RH ve BH grupları arasında rekürrens açısından farklılık yoktu (p= 0.53). İleri yaş, derin myometrial invazyon ve az sayıda lenf nodu çıkartılması rekürrens ile ilişkiliydi. Evre II endometriyum kanserinde radikal cerrahilere ve farklı adjuvan radyoterapi protokollerine rağmen rekürrenslerin ve mortalitenin esas sorumlusu uzak metastazlardır. Bundan dolayı, uzak metastazları engelleyebilmek için sistemik adjuvan tedavi bu hastalığın birinci basamak tedavisinde düşünülebilir.