[show abstract][hide abstract] ABSTRACT: Objective: In this study the effect of histologic subtype as a surgicopathologic risk factor in endometrial cancer is evaluated.Material and Methods: We evaluated 182 patients who underwent systematic lymphadenectomy up to the level of the renal vessels and at least 15 lymph nodes were dissected from the pelvic area and 10 lymph nodes from the para-aortic area. investigation of whether endometrioid and aggressive cell types (serous papillary cell and clear cell) affect the distribution of surgicopathologic risk factors among endometrial cancer cases was carried out.Results: Patients in the aggressive cell type group were older and the tumor size was significantly smaller. There was no difference between the two groups for the total number of dissected lymph nodes except for the external iliac area. Although the difference is not statistically significant, the total number of lymph nodes dissected in the aggressive group was less (54.3 vs 62.9, p=0.067) than that of the endometrioid cell type group. While the incidence of pelvic lymph node metastasis in the aggressive group was 59.1% the incidence was 15.6% in the endometrioid cell type group (p>0.001). The possibility of lymph node metastasis for aggressive cell type endometrial carcinoma in the para-aortic area was twice the endometrioid cell type group. It was found that the presence and type (stromal/glandular) of cervical invasion, depth of myometrial invasion and presence of lymphovascular space invasion were not affected by cell type.Conclusion: Aggressive cell types significantly increase the adnexial and lymph node metastasis in endometrial cancer.
Journal of the Turkish-German Gynecological Association. 01/2011;
[show abstract][hide abstract] ABSTRACT: Objective: The aim of the study is to evaluate and compare the efficacy of neoadjuvant chemotherapy (NACT), radical hysterectomy (RH) and radiotherapy (RT) in the treatment of stage IB2 cervical cancer.Material and Methods: Medical records of 86 patients with stage IB2 cervical cancer between 1993 and 2006 were evaluated. Patients who underwent type III RH ± bilateral salphingo-oophorectomy and para-aortic and pelvic lymphadenectomy constituted the RH group (n=18). Patients who received radiotherapy constituted the RT group (n=20). Patients who underwent any of the combination chemotherapies (cisplatin/5-fluorouracyl, cisplatin/UFT® or paclitaxel/carboplatin) followed by RH or RT constituted the NACT group (n=36).Results: Seventy-four patients were included in the study. The median follow-up was 48.5 months and the mean tumor size was 51.4mm. The groups were similar in terms of follow-up duration and tumor size. However, the mean age of the patients was higher in the RT group and nonsquamous type cervical cancer was more frequent in the RH group. Disease free survival (DFS) and overall survival (OS) were 75.7%. DFS rate was 65% in the RT group, 77.8% in the RH group and 80.6% in the NACT group. OS rates were 65%, 77.8% and 83.3% respectively. The groups were similar in terms of DFS and OS rates.Conclusion: In our study, none of the treatment modalities were shown to be superior in terms of efficacy. There is need for additional prospective studies comparing multimodal treatment regimens in stage IB2 cervical cancer.
Journal of the Turkish-German Gynecological Association. 01/2010;