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Barquet-Muñoz SA, Cantú-de-León D, Bandala-Jacques A, González-Enciso A, Isla-Ortiz D, Prada D, Herrera LA, Salcedo-Hernández RA. What is the impact of radical hysterectomy on endometrial cancer with cervical involvement? World J Surg Oncol 2020; 18:101. [PMID: 32438919 PMCID: PMC7243320 DOI: 10.1186/s12957-020-01876-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 05/07/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND When endometrial carcinoma invades the cervical stroma, overall survival and disease-free survival decrease. However, it is still controversial whether patients in suspected stage II should be treated with radical hysterectomy. The goal of this study is to describe the role of radical hysterectomy in patients with endometrial carcinoma and cervical involvement. METHODS This was a retrospective cohort study were a total of 239 patients with endometrial carcinoma with cervical involvement from Mexico City's National Cancer Institute were divided according to the type of hysterectomy, and the outcomes were compared using statistical analysis. RESULTS The 5-year overall survival was 75.76% for the simple hysterectomy group and 89.19% for the radical hysterectomy group, without achieving statistical significance. The 5-year disease-free survival was 72.95% for the simple hysterectomy group and 64.31% for the radical hysterectomy group, without achieving statistical significance. Radicality was associated with longer surgical times, intraoperative complications, and bleeding over 500 ml. CONCLUSIONS In patients with endometrial carcinoma with cervical involvement, radical hysterectomy does not improve prognosis or alter adjuvant therapy.
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Affiliation(s)
- Salim Abraham Barquet-Muñoz
- Departamento de Ginecología, Instituto Nacional de Cancerología, San Fernando 22, Tlalpan, 14080, Mexico City, Mexico
| | - David Cantú-de-León
- Departamento de Ginecología, Instituto Nacional de Cancerología, San Fernando 22, Tlalpan, 14080, Mexico City, Mexico.,Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología, Mexico City, Mexico.,Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Antonio Bandala-Jacques
- Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología, Mexico City, Mexico.,Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | | | - David Isla-Ortiz
- Departamento de Ginecología, Instituto Nacional de Cancerología, San Fernando 22, Tlalpan, 14080, Mexico City, Mexico
| | - Diddier Prada
- Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología, Mexico City, Mexico.,Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City, Mexico.,Departamento de Informática Biomédica, Faculty of Medicine, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Luis A Herrera
- Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología, Mexico City, Mexico.,Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City, Mexico.,Instituto Nacional de Medicina Genómica, Mexico City, Mexico
| | - R A Salcedo-Hernández
- Departamento de Ginecología, Instituto Nacional de Cancerología, San Fernando 22, Tlalpan, 14080, Mexico City, Mexico.
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Hasegawa T, Furugori M, Kubota K, Asai-Sato M, Yashiro-Kawano A, Kato H, Oi Y, Shigeta H, Segawa K, Kitagawa M, Mine Y, Saji H, Numazaki R, Maruyama Y, Ohnuma E, Taniguchi H, Sugiura K, Miyagi E, Matsunaga T. Does the extension of the type of hysterectomy contribute to the local control of endometrial cancer? Int J Clin Oncol 2019; 24:1129-1136. [PMID: 31069549 PMCID: PMC6687671 DOI: 10.1007/s10147-019-01458-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 04/25/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To examine the necessity and sufficiency of different types of hysterectomy for the surgical treatment of endometrial cancer. METHODS This was a multicenter collaborative study conducted by 11 institutions. Among patients with stage I-III endometrial cancer who underwent surgery as the initial treatment (only chemotherapy was provided if adjuvant therapy was needed) from 2001 to 2012, we retrospectively examined the type of hysterectomy, clinicopathological factors, recurrence rate over a maximum period of 5 years, and the site of recurrence. The local recurrence rate was examined by univariate and multivariate analyses. RESULTS Among 1335 patients, 982 (73.6%) underwent simple hysterectomy (SH) and 353 (26.4%) underwent modified radical hysterectomy (mRH) and were observed for a mean duration of 51.8 months. No significant difference was observed in the rate of local recurrence between the SH and mRH groups (p = 0.928). In multivariate analysis, clinicopathological factors independently associated with localized recurrence included postmenopausal status [hazard ratio (HR) 5.036, 95% confidence interval (CI) 1.506-16.841, p = 0.009], with stages II (HR 3.337, 95% CI 1.701-6.547, p < 0.001) and III (HR 2.445, 95% CI 1.280-4.668, p = 0.007), vs stage I and histological type 2 (HR 1.610, 95% CI 0.938-2.762, p = 0.001). CONCLUSIONS For endometrial cancer patients requiring surgery, the selection of a more extensive type of hysterectomy did not reduce the rate of local recurrence. Therefore, there is little significance in performing mRH in such cases.
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Affiliation(s)
- Tetsuya Hasegawa
- Yamato Municipal Hospital, 8-3-6 Fukaminishi, Yamato, Kanagawa 242-8602 Japan
| | - Megumi Furugori
- Yamato Municipal Hospital, 8-3-6 Fukaminishi, Yamato, Kanagawa 242-8602 Japan
| | - Kazumi Kubota
- Department of Obstetrics and Gynecology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004 Japan
| | - Mikiko Asai-Sato
- Department of Obstetrics and Gynecology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004 Japan
| | - Aiko Yashiro-Kawano
- Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa 241-8515 Japan
| | - Hisamori Kato
- Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa 241-8515 Japan
| | - Yuka Oi
- Yokohama Municipal Citizen’s Hospital, 56 Okazawa-chou, Hodogaya-ku, Yokohama, Kanagawa 240-8555 Japan
| | - Hiroyuki Shigeta
- Yokohama Municipal Citizen’s Hospital, 56 Okazawa-chou, Hodogaya-ku, Yokohama, Kanagawa 240-8555 Japan
| | - Keiko Segawa
- Saiseikai Yokohamashi Nanbu Hospital, 3-2-10 Kounanndai, Kounan-ku, Yokohama, Kanagawa 234-0054 Japan
| | - Masakazu Kitagawa
- Yokohama City University Medical Center, 4-57 UraFune-cho, Minami-ku, Yokohama, Kanagawa 232-0024 Japan
| | - Yuko Mine
- Fujisawa City Hospital, 2-6-1 Fujisawa, Fujisawa, Kanagawa 251-8550 Japan
| | - Haruya Saji
- Fujisawa City Hospital, 2-6-1 Fujisawa, Fujisawa, Kanagawa 251-8550 Japan
| | - Reiko Numazaki
- Yokohama Minamikyosai Hospital, 1-21-1 Mutsuurahigashi, Kanazawa-ku, Yokohama, Kanagawa 236-0037 Japan
| | - Yasuyo Maruyama
- Odawara Municipal Hospital, 46 Hisano, Odawara, Kanagawa 250-8558 Japan
| | - Emi Ohnuma
- Yokohama Rosai Hospital, 3211 Kodukue-chou, Kouhoku-ku, Yokohama, Kanagawa 222-0036 Japan
| | - Hanako Taniguchi
- Yokosuka Kyosai Hospital, 1-16 Yonegahamadouri, Yokosuka, Kanagawa 238-8558 Japan
| | - Ken Sugiura
- Yokosuka Kyosai Hospital, 1-16 Yonegahamadouri, Yokosuka, Kanagawa 238-8558 Japan
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004 Japan
| | - Tatsuya Matsunaga
- Department of Obstetrics and Gynecology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004 Japan
| | - Yokohama City University Gynecologic Oncology Research Group (YCUGO-ReG)
- Yamato Municipal Hospital, 8-3-6 Fukaminishi, Yamato, Kanagawa 242-8602 Japan
- Department of Obstetrics and Gynecology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004 Japan
- Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa 241-8515 Japan
- Yokohama Municipal Citizen’s Hospital, 56 Okazawa-chou, Hodogaya-ku, Yokohama, Kanagawa 240-8555 Japan
- Saiseikai Yokohamashi Nanbu Hospital, 3-2-10 Kounanndai, Kounan-ku, Yokohama, Kanagawa 234-0054 Japan
- Yokohama City University Medical Center, 4-57 UraFune-cho, Minami-ku, Yokohama, Kanagawa 232-0024 Japan
- Fujisawa City Hospital, 2-6-1 Fujisawa, Fujisawa, Kanagawa 251-8550 Japan
- Yokohama Minamikyosai Hospital, 1-21-1 Mutsuurahigashi, Kanazawa-ku, Yokohama, Kanagawa 236-0037 Japan
- Odawara Municipal Hospital, 46 Hisano, Odawara, Kanagawa 250-8558 Japan
- Yokohama Rosai Hospital, 3211 Kodukue-chou, Kouhoku-ku, Yokohama, Kanagawa 222-0036 Japan
- Yokosuka Kyosai Hospital, 1-16 Yonegahamadouri, Yokosuka, Kanagawa 238-8558 Japan
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Jiang Y, Jia N, Zhu M, He Y, Che X, Lv T, Feng W. Comparison of survival and perioperative outcomes following simple and radical hysterectomy for stage II endometrial cancer: a single-institution, retrospective, matched-pair analysis. J Int Med Res 2019; 47:4469-4481. [PMID: 31357882 PMCID: PMC6753566 DOI: 10.1177/0300060519863190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective We aimed to compare the survival and perioperative outcomes of patients with
stage II endometrial cancer (EC) undergoing simple hysterectomy (SH) or
radical hysterectomy (RH), to validate the various guidelines. Methods A total of 155 consecutive patients diagnosed with stage II EC from 2000 to
2014 were reviewed. We identified 40 pairs of patients (40 SH and 40 RH) who
were matched in terms of age, pathological type, and lymphovascular space
invasion status using matched-pair analysis. Patient data were collected
from medical records and outcomes were determined by telephone
follow-up. Results Among the 80 patients in the two groups, seven died from tumor recurrence.
However, cancer-related survival rates were not significantly different
between the SH and RH groups. The 3-year cancer-related survival rates in
the SH and RH groups were 94.97% and 92.53%, and the 5-year survival rates
were 92.40% and 90.03%, respectively. Regarding perioperative outcomes, the
SH group had significantly less intraoperative bleeding and a significantly
shorter catheter-indwelling time than the RH group. Conclusions SH provides similar survival outcomes and a superior perioperative quality of
life compared with RH in patients with stage II EC.
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Affiliation(s)
- Yahui Jiang
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Nan Jia
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Menghan Zhu
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Yuan He
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Xiaoxia Che
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Tianjiao Lv
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Weiwei Feng
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.,Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China
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