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Am J Obstet Gynecol. 2000 Jun;182(6):1506-19.

Low-risk corpus cancer: is lymphadenectomy or radiotherapy necessary?

Author information

1
Department of Obstetrics and Gynecology, Mayo Clinic and Mayo Foundation, Rochester, MN 55905, USA.

Abstract

OBJECTIVE:

The objective of this study was to find readily ascertainable intraoperative pathologic indicators that would discriminate a subgroup of early corpus cancers that would not require lymphadenectomy or adjuvant radiotherapy.

STUDY DESIGN:

Between 1984 and 1993, a total of 328 patients with endometrioid corpus cancer, grade 1 or 2 tumor, myometrial invasion < or =50%, and no intraoperative evidence of macroscopic extrauterine spread were treated surgically. Pelvic lymphadenectomy was performed in 187 cases (57%), and nodes were positive in nine cases (5%). Adjuvant radiotherapy was administered to 65 patients (20%). Median follow-up was 88 months.

RESULTS:

The 5-year overall cancer-related and recurrence-free survivals were 97% and 96%, respectively. Primary tumor diameter and lymphatic or vascular invasion significantly affected longevity. No patient with tumor diameter < or =2 cm had positive lymph nodes or died of disease.

CONCLUSION:

Patients who have International Federation of Gynecology and Obstetrics grade 1 or 2 endometrioid corpus cancer with greatest surface dimension < or =2 cm, myometrial invasion < or =50%, and no intraoperative evidence of macroscopic disease can be treated optimally with hysterectomy only.

PMID:
10871473
DOI:
10.1067/mob.2000.107335
[Indexed for MEDLINE]

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