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Title: Prognostic effect of isolated paraaortic nodal spread in endometrial cancer
Authors: Türkmen, Osman
Başaran, Derman
Karalok, Alper
Kimyon, Günsu Cömert
Taşçı, Tolga
Üreyen, Işın
Tulunay, Gökhan
Turan, Taner
Keywords: Endometrial cancer
paraaortic lymph node metastasis
serosal involvement
Issue Date: Dec-2018
Publisher: Galenos Yayıncılık
Source: Türkmen, O., Başaran, D., Karalök, A., Kimyon, G. C., Taşçı, T., Üreyen, I., ... & Turan, T. (2018). Prognostic effect of isolated paraaortic nodal spread in endometrial cancer. Journal of the Turkish German Gynecological Association, 19(4), 201.
Abstract: Objective: To evaluate the prognostic effect of isolated paraaortic lymph node metastasis in endometrial cancer (EC). Material and Methods: This retrospective study included patients with FIGO 2009 stage IIIC2 disease due to isolated paraaortic lymph node metastasis (LNM). Patients with sarcomatous histology, synchronous gynecologic cancers and patients with concurrent pelvic lymph node metastases or patients that have intraabdominal tumor spread were excluded. Kaplan-Meier method was used for calculation of progression free survival (PFS) and overall survival. Results: One thousand six hundred and fourteen patients were operated for EC during study period. Nine hundred and sixty-one patients underwent lymph node dissection and 25 (2.6%) were found to have isolated LNM in paraaortic region and these constituted the study cohort. Twenty (80%) patients had endometrioid EC. Median number of retrieved lymph nodes from pelvic region and paraaortic region was 21.5 (range: 5-41) and 34.5 (range: 1-65), respectively. Median number of metastatic paraaortic nodes was 1 (range: 1-32). The median follow-up time was 15 months (range 5-94). Seven (28%) patients recurred after a median of 20 months (range, 3-99) from initial surgery. Three patients recurred only in pelvis, one patient had upper abdominal spread and 3 had isolated extraabdominal recurrence. Involvement of uterine serosa, positive peritoneal cytology and presence of adnexal metastasis were significantly associated with diminished PFS (p<0.05). Conclusion: The presence of serosal involvement or adnexal involvement is as important as gross peritoneal spread and is related with poor survival in patients with isolated paraaortic nodal spread in EC. Chemotherapy should be the mainstay of treatment in this patient cohort which may eradicate systemic tumor spread.
ISSN: 1309-0399
Appears in Collections:Cerrahi Tıp Bilimleri Bölümü / Department of Surgical Sciences
PubMed İndeksli Yayınlar Koleksiyonu / PubMed Indexed Publications Collection
Scopus İndeksli Yayınlar Koleksiyonu / Scopus Indexed Publications Collection
TR Dizin İndeksli Yayınlar / TR Dizin Indexed Publications Collection
WoS İndeksli Yayınlar Koleksiyonu / WoS Indexed Publications Collection

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