have surgical pathologic findings consistent with more ad-A survey of American gynecologic oncologists was undertaken vanced disease than was clinically predicted.In addition, to assess their compliance with current surgical staging criteria in this change was based on the prospective surgical staging patients with early endometrial carcinoma.One hundred fortystudies conducted by the Gynecologic Oncology Group, four members of the Society of Gynecologic Oncologists responded which demonstrated that prognosis is related to the presence to the survey.Respondents treated an average of 22 new cases or absence of surgically determined uterine and extrauterine annually.Tumor grade and intraoperative determination of depth risk factors [2, 3].Since clinical staging is performed preopof myometrial invasion were demonstrated to influence the freeratively and is not altered by subsequent surgical findings, quency of lymphatic dissection.In grade 1, 2, and 3 lesions, 76, many patients staged in this manner are not classified ac-60, and 34% of responders, respectively, indicated that depth of cording to the true extent of their disease.Because surgical invasion influenced their decision to perform lymphadenectomy. staging is intended to identify patients who may or may notIn addition, depth of invasion was important in determining type and extent of lymphatic resection.Further, the impact of patho-require adjuvant therapy, and to obtain comparable material logic lymph node status on postoperative adjuvant radiation therfor the purpose of assessing the results of treatments statistiapy recommendations was evaluated for various stratifications of cally, the more accurate method was adopted [4].endometrial adenocarcinoma confined to the corpus.The greatest Despite the acknowledged advantages of the surgical clasdifferences in treatment recommendations were noted in the 50sification, controversy remains regarding the actual necessity 66% invasion category.For grade 1 and 2 cancers, adjuvant therand benefit of extended surgical staging of early (clinical apy recommendations were reduced by 23 and 16% respectively stage I) endometrial carcinomas.While some authors report when comparing pelvic and combined therapy versus none and no benefit [5], others argue that the additional information vaginal therapy.The effect of surgical staging data on clinical gained from complete staging may optimize the prescription decisions is clearly evident.The knowledge of pathologically negaof postoperative adjuvant therapy [6, 7].Furthermore, Kiltive lymph node status reduces the recommendation for postoperative adjuvant radiotherapy in patients with adenocarcinoma other-gore et al. recently reported a survival advantage for patients wise confined to the uterine corpus.᭧ 1996 Academic Press, Inc.who undergo multiple-site pelvic node sampling [8].The pivotal issues are whether all patients require lymphadenectomy and which lymph node groups should be resected.
No takes yet. Share an insight, caveat, or question.
Gretz et al. (1996) studied this question.