The practice of surgical staging and its impact on adjuvant treatment recommendations in patients with stage I endometrial carcinoma.
The practice of surgical staging and its impact on adjuvant treatment recommendations in patients with stage I endometrial carcinoma.
复制标题
手术分期的实践及其对 I 期子宫内膜癌患者辅助治疗建议的影响。
DOI：
10.1006/gyno.1996.0165
复制
发表时间：
1996
影响因子：
4.7
通讯作者：
Roberts,JA
中科院分区：
文献类型：
--
作者：
GretzHF3rd;Economos,K;Husain,A;Lesser,M;Kaplan,E;Caputo,TA;Reynolds,RK;Johnston,CM;Pearl,ML;Roberts,JA
对美国妇科肿瘤学家进行了一项调查，以评估他们对早期子宫内膜癌患者现行手术分期标准的遵守情况。妇科肿瘤学家协会的 144 名会员对这项调查做出了回应。受访者平均每年治疗 22 个新病例。肿瘤分级和术中确定子宫肌层浸润深度会影响淋巴清扫的频率。在 1 级、2 级和 3 级病变中，分别有 76%、60% 和 34% 的应答者表示，浸润深度影响了他们进行淋巴结切除术的决定。此外，浸润深度对于确定淋巴切除的类型和范围也很重要。此外，针对局限于子宫体的子宫内膜腺癌的各种分层，评估了病理淋巴结状态对术后辅助放射治疗建议的影响。治疗建议的最大差异出现在 50-66% 侵袭类别中。对于 1 级和 2 级癌症，在比较盆腔治疗和联合治疗与无治疗和阴道治疗时，辅助治疗建议分别减少了 23% 和 16%。手术分期数据对临床决策的影响是显而易见的。了解病理学阴性的淋巴结状态可以减少对局限于子宫体的腺癌患者进行术后辅助放疗的建议。
A survey of American gynecologic oncologists was undertaken to assess their compliance with current surgical staging criteria in patients with early endometrial carcinoma. One hundred forty-four members of the Society of Gynecologic Oncologists responded to the survey. Respondents treated an average of 22 new cases annually. Tumor grade and intraoperative determination of depth of myometrial invasion were demonstrated to influence the frequency of lymphatic dissection. In grade 1, 2, and 3 lesions, 76, 60, and 34% of responders, respectively, indicated that depth of invasion influenced their decision to perform lymphadenectomy. In addition, depth of invasion was important in determining type and extent of lymphatic resection. Further, the impact of pathologic lymph node status on postoperative adjuvant radiation therapy recommendations was evaluated for various stratifications of endometrial adenocarcinoma confined to the corpus. The greatest differences in treatment recommendations were noted in the 50–66% invasion category. For grade 1 and 2 cancers, adjuvant therapy recommendations were reduced by 23 and 16% respectively when comparing pelvic and combined therapy versus none and vaginal therapy. The effect of surgical staging data on clinical decisions is clearly evident. The knowledge of pathologically negative lymph node status reduces the recommendation for postoperative adjuvant radiotherapy in patients with adenocarcinoma otherwise confined to the uterine corpus.