Significance of comprehensive surgical staging in noninvasive papillary serous carcinoma of the endometrium
Significance of comprehensive surgical staging in noninvasive papillary serous carcinoma of the endometrium
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DOI：
10.1016/s0090-8258(03)00195-1
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发表时间：
2003-07-01
影响因子：
4.7
通讯作者：
Berman, ML
中科院分区：
文献类型：
--
作者：
Chan, JK;Loizzi, V;Berman, ML
客观的。评价子宫内膜非浸润性乳头状浆液性癌的生物学行为。方法。从 1990 年到 2001 年，南加州三家医院所有患有非侵袭性子宫乳头状浆液性癌 (UPSC) 的女性均通过肿瘤登记数据库进行了识别。用于分析的数据是从医院图表、办公室记录和肿瘤登记文件中收集的。结果。在 100 名诊断为 UPSC 的患者中，16 名患有非侵袭性病变。十二人接受了全面的手术分期手术，包括大网膜切除术。这12名女性中，有6名被发现患有子宫体以外的疾病，其中4名有附件受累，3名有大网膜疾病，2名有宫颈扩张，1名有盆腔淋巴结受累，3名冲洗液阳性。三名女性被发现细胞学检查呈阳性，且多处有转移。在这 12 名患者中，6 名 IA 期疾病患者中有 1 名出现远处复发，6 名 II-IV 期疾病患者中有 4 名复发。其余 4 名接受分期手术但未进行病理大网膜评估的患者中，我被发现存在颈椎伸展。在这 4 名女性中，我的 IA 期疾病复发。结论。子宫内膜样癌的典型扩散模式和预后因素不适用于 UPSC。在我们的系列中，有必要进行大网膜评估，以检测 25% 因大网膜受累而患有 IVB 期疾病的患者。因此，患有非侵入性 UPSC 的女性应接受全面的分期程序，包括大网膜取样以确定疾病的程度。 (C) 2003 年爱思唯尔科学（美国）。版权所有。
Objective. To evaluate the biological behavior of noninvasive papillary serous carcinoma of the endometrium.Methods. From 1990 to 2001, all women with noninvasive uterine papillary serous carcinoma (UPSC) at three Southern California hospitals were identified from tumor registry databases. Data for analysis were collected from hospital charts, office records, and tumor registry files.Results. Of the 100 patients diagnosed with UPSC, 16 had noninvasive lesions. Twelve underwent a comprehensive surgical staging procedure with omental resection. Six of these 12 women were found to have disease beyond the uterine corpus, including 4 with adnexal involvement, 3 with omental disease, 2 with cervical extension, I with pelvic lymph node involvement, and 3 with positive washings. Three women were found to have positive cytology and metastases in more than one location. Of the 12 patients, 1 of the 6 with stage IA disease had distant recurrence and 4 of the 6 with stage II-IV disease recurred. Of the remaining 4 patients who underwent a staging procedure without pathologic omental assessment, I was found to have cervical extension. In these 4 women, I with stage IA disease recurred.Conclusion. The typical patterns of spread and prognostic factors for endometrioid carcinoma of the uterus do not apply to UPSC. In our series, omental assessment was necessary to detect the 25% of patients with stage IVB disease due to omental involvement. Thus, women with noninvasive UPSC should undergo a comprehensive staging procedure including omental sampling to determine the extent of disease. (C) 2003 Elsevier Science (USA). All rights reserved.