Abstract：
PURPOSE:To determine, in patients with non-endometrioid endometrial carcinoma, 1) survival benefit associated with pelvic lymphadenectomy (LND), 2) survival benefit for para-aortic lymphadenectomy performed in addition to pelvic lymphadenectomy, and 3) association between number of lymph nodes removed and survival. METHODS:Patients with clinical stage I serous carcinoma, clear cell carcinoma, or carcinosarcoma who underwent hysterectomy from 2010 to 2013 were identified from the National Cancer Database. Hazard ratio (HR) for death was assessed using propensity score-weighted multivariable Cox regression models. Subgroup analyses assessed for differences in risk of death among histologic subtypes. RESULTS:7250 patients met study criteria. 930 (13%) did not undergo LND; 2177 (30%) underwent pelvic LND alone; 4143 (57%) underwent pelvic+para-aortic LND. On propensity score-weighted analysis, pelvic LND was associated with decreased risk of death (HR=0.65, 95% CI: 0.59-0.71) compared to no LND. Pelvic+para-aortic LND was associated with decreased risk of death (HR=0.85, 95% CI: 0.79-0.91) compared to pelvic LND for patients with serous carcinoma. Removal of >15 nodes was independently associated with decreased HR for death (HR=0.86, 95% CI: 0.77-0.96); this association persisted when analysis was limited to patients with node-positive disease (HR=0.78, 95% CI: 0.63-0.95). CONCLUSIONS:LND is associated with survival benefit in patients with non-endometrioid endometrial cancers. Addition of para-aortic LND to pelvic LND may be most beneficial for patients with serous carcinoma. Systematic lymphadenectomy may be associated with survival benefit through detection and microscopic cytoreduction of occult disease.
journal_name
Gynecol Oncoljournal_title
Gynecologic oncologyauthors
Venigalla S,Chowdhry AK,Shalowitz DIdoi
10.1016/j.ygyno.2018.03.046subject
Has Abstractpub_date
2018-06-01 00:00:00pages
531-538issue
3eissn
0090-8258issn
1095-6859pii
S0090-8258(18)30218-Xjournal_volume
149pub_type
杂志文章abstract：OBJECTIVE:Different histologic types of epithelial ovarian cancer may represent different diseases with unique clinical and molecular characteristics. Clear cell carcinoma (CCC) of the ovary has been reported as having a worse prognosis than high grade serous epithelial ovarian cancer (EOC). This article critically rev...
journal_title：Gynecologic oncology
pub_type： 杂志文章,评审
doi：10.1016/j.ygyno.2012.04.021
更新日期：2012-09-01 00:00:00
abstract：OBJECTIVE:High-risk types of HPV are etiological factors in cervical cancer. Lymph node involvement in cervical cancer patients reduces 5-year survival rates by 25-60%. However, the influence on survival of HPV DNA positivity in histopathologically negative lymph nodes remains unresolved. METHODS:The study included 11...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1016/j.ygyno.2006.10.018
更新日期：2007-03-01 00:00:00
abstract：:Cyclin D1 is a critical gene controlling the G1 phase progression through the cell cycle. Alterations of cyclin D1 have been demonstrated in a variety of cancer types. We recently reported that increased cyclin D1 expression is associated with malignancy also in ovarian tumors. Three human ovarian cancer cell lines (S...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1006/gyno.1998.5062
更新日期：1998-09-01 00:00:00
abstract：:Adenocarcinoma in situ (AIS) of the cervix is a controversial entity which is being encountered with increasing frequency. Current critical issues in its management are the safety of uterine preservation in younger patients and the use of LLETZ conization. A 28-year-old patient was diagnosed with AIS and managed with ...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1006/gyno.1995.1226
更新日期：1995-08-01 00:00:00
abstract：BACKGROUND:Evidence on the incidence and risk factors for lower limb lymphedema (LLL) associated with endometrial cancer is limited. Our objective was to use data from a prospective, longitudinal gynecological cancer cohort study to determine LLL incidence up to 24 months post-diagnosis of endometrial cancer and to exp...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1016/j.ygyno.2020.04.702
更新日期：2020-08-01 00:00:00
abstract：OBJECTIVES:To determine prognostic factors for survival in ovarian cancer patients treated with intraperitoneal (IP) chemotherapy using ancillary data from cooperative group clinical trials. METHODS:Data were collected from 428 patients with stage III ovarian cancer who underwent optimal surgical cytoreduction (<1 cm)...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1016/j.ygyno.2013.04.001
更新日期：2013-07-01 00:00:00
abstract：OBJECTIVES:Early detection of ovarian cancer should improve overall survival. Multiple serum markers have been evaluated as possible tests to detect early stage disease, but few urine markers have been studied. Mesothelin has been detected in serum from patients with ovarian cancer, but has not been previously reported...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1016/j.ygyno.2007.04.022
更新日期：2007-09-01 00:00:00
abstract：:The purpose of this study was to evaluate the differences of blood supply in benign and malignant breast tumors by color Doppler flow measurements. The study included 471 patients, 133 with carcinomas, 325 with benign breast lesions, and 13 with mastitis. An ATL UM9/HDI was used with an electronic 10-MHz linear array ...
journal_title：Gynecologic oncology
pub_type： 临床试验,杂志文章
doi：10.1006/gyno.1996.4585
更新日期：1997-03-01 00:00:00
abstract：:Between 1969 and 1988, 401 patients were treated by radical hysterectomy and pelvic lymphadenectomy for Stage IB cervical carcinoma at the University of Alabama at Birmingham. In multivariate analysis, pathological tumor diameter (P less than 0.0001) and the presence of lymph node metastasis (P = 0.0005) proved to be ...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1016/0090-8258(91)90054-9
更新日期：1991-11-01 00:00:00
abstract：OBJECTIVES:The objective of this study was to determine whether ovarian preservation is feasible in younger endometrial cancer patients. METHODS:Endometrial cancer patients who underwent ovary-saving surgery were recruited from the tumor registries of 14 tertiary hospitals under the influence of the Korean Gynecologic...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1016/j.ygyno.2009.06.041
更新日期：2009-10-01 00:00:00
abstract：OBJECTIVE:Based on previous studies, standard gynecological screening consisting of annual transvaginal ultrasonography (TVU) was added with endometrial sampling in women with Lynch syndrome (LS). The aim of this study was to evaluate the additional value of endometrial sampling in detecting (pre)malignancies of the en...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1016/j.ygyno.2013.05.032
更新日期：2013-11-01 00:00:00
abstract：OBJECTIVES:We previously reported high rates of urinary incontinence among gynecologic cancer survivors and aimed to evaluate the effectiveness of a simple intervention for treatment of urinary incontinence in this population. METHODS:We recruited 40 gynecologic cancer survivors who reported urinary incontinence on a ...
journal_title：Gynecologic oncology
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.ygyno.2013.10.024
更新日期：2014-01-01 00:00:00
abstract：:CA 125 was measured during early chemotherapy in 121 patients with FIGO stage III or IV ovarian cancer to investigate if the antigen could be used as a prognostic parameter. CA 125 was determined before the start of chemotherapy and 1 month after the first, second, and third course. The antigen level before the start ...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1016/0090-8258(92)90043-i
更新日期：1992-03-01 00:00:00
abstract：UNLABELLED:Misconceptions about cancer may increase the level of fear in the general public and render coping more difficult in cancer patients. The aim of this survey was to study the level of knowledge and misconceptions. MATERIALS AND METHODS:A questionnaire comprising 27 questions related to cancer etiology, treat...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1006/gyno.1997.4626
更新日期：1997-04-01 00:00:00
abstract：OBJECTIVE:This study aims to identify favorable preoperative characteristics and examine the impact of secondary cytoreductive surgery on survival for patients with recurrent epithelial ovarian carcinoma. METHODS:Patients who underwent cytoreductive surgery for recurrent epithelial ovarian cancer were identified in ou...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1016/j.ygyno.2007.04.006
更新日期：2007-09-01 00:00:00
abstract：OBJECTIVE:To compare surgical morbidity and clinical-pathologic factors for patients with endometrial cancer (EC) undergoing robotic-assisted laparoscopic hysterectomy (RALH) versus total abdominal hysterectomy (TAH) with aortic and/or pelvic lymphadenectomy (LA). METHODS:During the first 14 months of a robotics surgi...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1016/j.ygyno.2008.08.025
更新日期：2008-12-01 00:00:00
abstract：:Human papillomaviruses (HPVs) are small double-stranded DNA viruses that infect the skin and internal squamous mucosae. These viruses were once considered to be the causal agent only of skin or genital warts--lesions of trivial significance. It turns out, however, that HPVs belong to a large virus family that includes...
journal_title：Gynecologic oncology
pub_type： 杂志文章,评审
doi：10.1016/j.ygyno.2010.04.002
更新日期：2010-06-01 00:00:00
abstract：OBJECTIVE:To evaluate the impact of introducing a robotics program on clinical outcome of elderly patients with endometrial cancer. METHODS:Evaluation and comparison of peri-operative morbidity and disease-free interval in 163 consecutive elderly patients (≥70years) with endometrial cancer undergoing staging procedure...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1016/j.ygyno.2014.03.572
更新日期：2014-06-01 00:00:00
abstract：OBJECTIVE:Lymph node status in endometrial cancer is a major prognostic factor. Sentinel lymph node (SLN) biopsy using radiocolloid and blue dye labeling has emerged as an alternative to systematic lymphadenectomy. This technique requires a preoperative lymphoscintigraphy. The aim of this study was to evaluate the limi...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1016/j.ygyno.2008.11.004
更新日期：2009-02-01 00:00:00
abstract：OBJECTIVE:The concept of "platinum sensitivity" has been widely applied in the management of recurrent ovarian cancer. This study aimed to evaluate the applicability of this concept to recurrent endometrial cancer. PATIENTS AND METHODS:In this multicenter retrospective cohort study, the clinical data of patients with ...
journal_title：Gynecologic oncology
pub_type： 杂志文章,多中心研究
doi：10.1016/j.ygyno.2013.09.021
更新日期：2013-12-01 00:00:00
abstract：:Mullerian Inhibiting Substance (MIS), a fetal testicular product that causes regression of the Mullerian duct in the male mammalian embryo, was evaluated for its antitumor effect on the premise that a substance active against this genital precursor in the fetus might also be active against tumors derived from these ti...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1016/0090-8258(85)90019-8
更新日期：1985-10-01 00:00:00
abstract：OBJECTIVE:To examine the effect of postsurgical surveillance on survival of patients with FIGO stage I/II endometrial adenocarcinoma. METHODS:We examined the records of 354 patients who underwent primary surgical therapy for FIGO stage I/II endometrial adenocarcinoma. In patients who developed recurrent disease, we de...
journal_title：Gynecologic oncology
pub_type： 临床试验,杂志文章
doi：10.1006/gyno.1995.1262
更新日期：1995-10-01 00:00:00
abstract：:Treatment of 102 patients with cancer of the cervix by class II and III radical hysterectomy was reviewed to compare the operative morbidity and efficacy of class II radical hysterectomy for select cases. Of the 102 patients, 21 had a class II hysterectomy, whereas 81 patients had a class III hysterectomy. The class I...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1016/0090-8258(91)90078-j
更新日期：1991-01-01 00:00:00
abstract：OBJECTIVES:Ovarian cancer remains a leading cause of death in women and development of new therapies is essential. Second mitochondria derived activator of caspase (Smac) has been described to sensitize for apoptosis. We have explored the proapoptotic activity of a small molecule mimic of Smac/DIABLO on ovarian cancer ...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1016/j.ygyno.2007.01.011
更新日期：2007-05-01 00:00:00
abstract：:A primary malignant mixed Mullerian tumor (MMMT) was found in the wall of the rectum of a 67-year-old female. The uterus, fallopian tubes, and ovaries had been previously excised for benign disease. The tumor was associated with foci of benign endometriosis. A literature review of extragenital MMMTs indicates that the...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1016/0090-8258(86)90228-3
更新日期：1986-02-01 00:00:00
abstract：INTRODUCTION:Vulvar squamous cell carcinoma (VSCC) commonly metastasises through groin lymphatics. However, the use of pre-operative imaging in detecting inguinal nodal metastasis before staging surgery or to triage patients for sentinel node biopsy remains unclear. Here, we investigated if pre-operative CT scan, the i...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1016/j.ygyno.2020.01.031
更新日期：2020-05-01 00:00:00
abstract：OBJECTIVE:To test if TP53 hot spot mutations (HSMs) confer differential chemotherapy resistance or survival outcomes, the effects of microtubule stabilizers on human ovarian carcinoma cells (OCCs) expressing TP53 HSMs were studied in vitro. Survival outcomes of patients with high grade serous epithelial ovarian carcino...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1016/j.ygyno.2015.04.039
更新日期：2015-07-01 00:00:00
abstract：BACKGROUND:Malignant struma ovarii is a rare tumor, consisting of a struma ovarii with malignant change. Because of the rarity of the tumor, only a few reports with detailed data of thyroid function of the patient have been published. CASE:Medical and surgical treatments were performed in a case of malignant struma ov...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1006/gyno.2000.5966
更新日期：2000-12-01 00:00:00
abstract：:Fifty consecutive patients with documented advanced or recurrent endometrial carcinoma from 1978 through 1985 were prospectively treated with melphalan, 5-fluorouracil, medroxyprogesterone acetate (MFP) as first-line chemotherapy. From 1987 through 1993, 50 consecutive patients with documented advanced or recurrent en...
journal_title：Gynecologic oncology
pub_type： 临床试验,杂志文章
doi：10.1006/gyno.1995.0015
更新日期：1995-11-01 00:00:00
abstract：BACKGROUND:The friable and hypervascular nature of a metastatic invasive mole places the patient at risk for significant hemorrhage. Bleeding is the chief cause of morbidity and mortality in patients with a histopathological diagnosis of invasive mole. Bleeding from vaginal metastatic lesions can be controlled by packi...
journal_title：Gynecologic oncology
pub_type： 杂志文章
doi：10.1006/gyno.1996.0171
更新日期：1996-06-01 00:00:00
