Article

A need for laparoscopic evaluation of patients with endometrial carcinoma selected for conservative treatment.

Service de Chirurgie Gynécologique, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex, France.
Gynecologic Oncology (impact factor: 3.89). 02/2005; 96(1):245-8. DOI:10.1016/j.ygyno.2004.09.034 pp.245-8
Source: PubMed

ABSTRACT The aim of this paper was to report two cases of extrauterine disease in patients with early stage endometrial cancer (EC) who desired fertility-sparing management.
Two patients presenting an apparent early stage EC and desiring conservative management. The two patients, aged 35 and 36 years old, had a grade 1 and grade 2 EC diagnosed after curettage or hysteroscopic resection of a polyp. Ultrasound (US) imaging was normal (ovary). Once informed about the risk of recurrence, both patients opted for conventional therapy (hysterectomy with bilateral salpingo-oophorectomy). A small ovarian carcinoma was found in one patient and isolated positive peritoneal cytology in the other.
These cases seem to suggest that laparoscopic evaluation including adnexal exploration and peritoneal cytology (and possibly pelvic lymphadenectomy) should be performed in patients with early stage EC selected for conservative management to confirm the absence of extrauterine disease.

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Keywords

36 years old
 
apparent
 
bilateral salpingo-oophorectomy
 
conservative management
 
conventional therapy
 
desiring conservative management
 
EC
 
extrauterine disease
 
grade 2 EC
 
hysterectomy
 
hysteroscopic resection
 
laparoscopic evaluation
 
ovary
 
pelvic lymphadenectomy
 
peritoneal cytology
 
positive peritoneal cytology
 
recurrence
 
small ovarian carcinoma
 
stage EC
 
two patients
 

Philippe Morice