E-viri
Recenzirano
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Pölcher, M.; Rottmann, M.; Brugger, S.; Mahner, S.; Dannecker, C.; Kiechle, M.; Brambs, C.; Grab, D.; Anthuber, C.; von Koch, F.; Schnelzer, A.; Engel, J.
Gynecologic oncology, July 2019, 2019-Jul, 2019-07-00, 20190701, Letnik: 154, Številka: 1Journal Article
According to current treatment guidelines, comprehensive surgical staging procedures in endometrial cancer confined to the uterus depend on uterine risk factors: a systematic lymph node dissection (LND) is recommended in high risk patients and should be omitted in low risk patients. Its role in intermediate and high intermediate risk patients is inconclusive. The aim of this analysis was to review the implementation of this risk-adopted strategy. Data were provided by the population-based Munich Cancer Registry. Patients with endometrial cancer diagnosed between 1998 and 2016 were included. Of 5446 eligible patients, 58.5%, 30.1% and 11.4% belonged to the low risk, intermediate/high-intermediate and high risk group, respectively. Lymph node dissection was performed in 20.2%, 53.0% and 63.7% within these groups. Lymph node involvement was diagnosed in 1.7%, 9.6% and 19.3%, respectively. Within these risk groups, there was no significant difference in the time to local recurrence, lymph node recurrence or distant metastases between patients with and without LND. After adjusting for age and comorbidity-status, no significant difference in overall survival was found. The application of a risk-adopted management of LND in early endometrial cancer in real-life is associated with a high rate of surgical under- and overtreatment. Corresponding survival data do not show a significant benefit of a systematic lymph node dissection. In order to improve the management and outcome of early endometrial cancer in the future, prospective trials, new surgical concepts and prognostic markers will be primary and necessary. •Although it is recommended, a high proportion of patients had no lymph node surgery.•The incidence of recurrence seems not to be related to lymph node dissection.•The comorbidity status should be considered in analyses of lymph node surgery.•The survival analysis challenges lymph node dissection in endometrial cancer.
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JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
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Vir: Osebne bibliografije
in: SICRIS
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