The Role of Comprehensive Surgical Staging in Patients With Endometrial Cancer
The Role of Comprehensive Surgical Staging in Patients With Endometrial Cancer
复制标题
DOI：
10.1177/107327480901600104
复制
发表时间：
2009-01-01
期刊：
影响因子：
2.6
通讯作者：
Straughn, J. Michael, Jr.
中科院分区：
文献类型：
--
作者：
Frederick, Peter J.;Straughn, J. Michael, Jr.
背景：子宫内膜癌患者治疗的基础是子宫切除术。自1988年以来，淋巴结切除术对子宫内膜癌患者的作用一直存在争议。接受盆腔和腹主动脉旁淋巴结清扫术的患者更有可能准确分期，不太可能接受辅助放射治疗。方法：作者进行了叙述性回顾最近的文献。总生存率，利用放射治疗，对生活质量的影响，和替代方法手术staging.Results：虽然从全面的手术分期的生存效益尚未明确证明在诊断为子宫内膜癌的患者，手术分期允许一个确定需要辅助治疗。术前和术中评估淋巴结转移和肿瘤分级缺乏准确性。未分期的患者更有可能接受术后放射治疗。结论：淋巴结切除术的综合手术分期可以使患者准确地分为风险类别。风险状态只能通过最终病理学确定。手术分期的患者更有可能在必要时接受适当的辅助治疗或观察。
Background: The cornerstone of the management of patients with endometrial cancer is hysterectomy. Since 1988, the role of lymphadenectomy for patients with endometrial cancer has been debated. Patients who undergo pelvic and para-aortic lymphadenectomy are more likely to be accurately staged and are less likely to receive adjuvant radiation therapy.Methods: The authors perform a narrative review of the recent literature. Overall survival, utilization of radiation therapy, impact on quality of life, and alternative approaches to surgical staging are discussed.Results: Although a survival benefit from comprehensive surgical staging has not been clearly demonstrated in patients diagnosed with endometrial cancer, surgical staging allows one to determine the need for adjuvant therapy. Preoperative and intraoperative assessment of lymph node metastasis and tumor grade lacks accuracy. Unstaged patients are more likely to receive postoperative radiation therapy.Conclusions: Comprehensive surgical staging with lymphadenectomy allows patients to be classified accurately into risk categories. Risk status can be definitively determined only with final pathology. Surgically staged patients are more likely to receive appropriate adjuvant therapy or observation when warranted.