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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2018.1
- 수록면
- 1 - 12 (12page)
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Objective: To assess the impact of lymph node dissection (LND) on morbidity, survival, and cost for intermediate-risk endometrial cancers (IREC). Methods: A multicenter retrospective cohort of 720 women with IREC (endometrioid histology with myometrial invasion <50% and grade 3; or myometrial invasion ≥50% and grades 1–2; or cervical involvement and grades 1–2) was carried out. All patients underwent hysterectomy and bilateral salpingo-oophorectomy. A matched pair analysis identified 178 pairs (178 with LND and 178 without it) equal in age, body mass index, co-morbidities, American Society of Anesthesiologist score, myometrial invasion, and surgical approach. Demographic data, pathology results, perioperative morbidity, and survival were abstracted from medical records. Disease-free survival (DFS) and overall survival (OS) was analyzed using Kaplan-Meier curves and multivariate Cox regression analysis. Cost analysis was carried out between both groups. Results: Both study groups were homogeneous in demographic data and pathologic results. The mean follow-up in patients free of disease was 61.7 months (range, 12.0–275.5). DFS (hazard ratio [HR]=1.34; 95% confidence interval [CI]=0.79–2.28) and OS (HR=0.72; 95% CI=0.42–1.23) were similar in both groups, independently of nodes count. In LND group, positive nodes were found in 10 cases (5.6%). Operating time and late postoperative complications were higher in LND group (p<0.05). Infection rate was significantly higher in no-LND group (p=0.035). There were no statistical differences between both groups regarding operative morbidity and hospital stay. The global cost was similar for both groups. Conclusion: Systematic LND in IREC has no benefit on survival, although it does not show an increase in perioperative morbidity or global cost.
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참고문헌 (28)
참고문헌 신청
Creasman WT / 1987 / Surgical pathologic spread patterns of endometrial cancer. A Gynecologic Oncology Group Study / Cancer 60:2035~2041
Benedet JL / 2000 / FIGO staging classifications and clinical practice guidelines in the management of gynecologic cancers. FIGO Committee on Gynecologic Oncology / Int J Gynaecol Obstet 70:209~262
American College of Obstetricians / 2005 / ACOG practice bulletin, clinical management guidelines for obstetrician-gynecologists, number 65, August 2005: management of endometrial cancer / Obstet Gynecol 106:413~425
Kilgore LC / 1995 / Adenocarcinoma of the endometrium: survival comparisons of patients with and without pelvic node sampling / Gynecol Oncol 56:29~33
Chan JK / 2006 / Therapeutic role of lymph node resection in endometrioid corpus cancer: a study of 12,333 patients / Cancer 107:1823~1830
Benedet JL / 2000 / FIGO staging classifications and clinical practice guidelines in the management of gynecologic cancers. FIGO Committee on Gynecologic Oncology / Int J Gynaecol Obstet 70:209~262
American College of Obstetricians / 2005 / ACOG practice bulletin, clinical management guidelines for obstetrician-gynecologists, number 65, August 2005: management of endometrial cancer / Obstet Gynecol 106:413~425
Kilgore LC / 1995 / Adenocarcinoma of the endometrium: survival comparisons of patients with and without pelvic node sampling / Gynecol Oncol 56:29~33
Chan JK / 2006 / Therapeutic role of lymph node resection in endometrioid corpus cancer: a study of 12,333 patients / Cancer 107:1823~1830
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