. The aim of this study was to evaluate the impact of the surgical approach on the management and outcomes of patients with early borderline ovarian tumors (BOTs). Material and methods. We retrospectively reviewed the.... The aim of this study was to evaluate the impact of the surgical approach on the management and outcomes of patients with early borderline ovarian tumors (BOTs). Material and methods. We retrospectively reviewed the medical charts of patients with stage Ia to Ic BOT treated surgically between January 1, 1985, and December 31, 2001. We compared patients initially managed by laparoscopy vs laparotomy in terms of potentially harmful procedures and quality of staging. Results. Of the 118 included patients, 48 (41% ) had laparoscopy for initial surgery, 54 (45% ) had laparotomy, and 16 (14% ) had conversion from laparoscopy to laparotomy. Conservative treatment (57% of patients) was more common with laparoscopy (vs laparotomy, P < 0.05) and in women older than 44 years (vs younger than 44 years, P < 0.001). Intraoperative tumor rupture occurred in 9% of patients and was not associated with the surgical approach (P = 0.1). Bag extraction was used in 19 (40% ) of the 48 laparoscopy patients. Staging was incomplete in 73% of patients overall. By univariate analysis, better quality of staging was associated with bilateral adnexectomy, age >44 years, laparotomy, hysterectomy, and treatment after 1995. By multivariate analysis, bilateral adnexectomy or hysterectomy was associated with better staging. Mean follow-up was 40 months, during which recurrence and survival rates were similar in the laparoscopy and laparotomy groups. Conclusion. Staging of macroscopic early stage BOTs was better in patients requiring radical surgery. After adjustment on disease severity, type of surgical access was not related to staging quality.展开更多
To evaluate detection rate, topography and false negatives of sentinel lymph node in endometrial cancer. Material and methods. Twenty-six patients were included. Lymphoscintigraphy was performed the day before surgery...To evaluate detection rate, topography and false negatives of sentinel lymph node in endometrial cancer. Material and methods. Twenty-six patients were included. Lymphoscintigraphy was performed the day before surgery. Preoperative detection of the sentinel lymph node was performed with cervical blue dye injection and a gamma probe. Separate pathology examinations were performed for sentinel and non-sentinel lymph nodes. Sentinel lymph nodes were examined with hematoxylin-eosin-safran stain, and immunohistochemistry if negative. Results. Twenty-six patients had a positive lymphoscintigraphy. Preoperative detection was successful in 21 patients (80.8% ): the detection rate with isotopic method, 19 cases (73.1% ), was superior to the dye detection, 15 cases (57.7% ). No isolated lombo-aortic sentinel lymph nodes were observed, and all sentinel lymph nodes were in the ilio-obturator region. Seven patients presented lymphatic spread, and 4 of them had at least one sentinel node. There was one micrometastasis in sentinel node, associated with isolated tumoral cells in pelvic lymphadenectomy. There was no false negative of sentinel node. Conclusion. The biopsy of sentinel lymph node is a feasible procedure in endometrial cancer. There was one micrometastatic sentinel node. However there was no isolated lombo-aortic sentinel lymph node in this study.展开更多
文摘. The aim of this study was to evaluate the impact of the surgical approach on the management and outcomes of patients with early borderline ovarian tumors (BOTs). Material and methods. We retrospectively reviewed the medical charts of patients with stage Ia to Ic BOT treated surgically between January 1, 1985, and December 31, 2001. We compared patients initially managed by laparoscopy vs laparotomy in terms of potentially harmful procedures and quality of staging. Results. Of the 118 included patients, 48 (41% ) had laparoscopy for initial surgery, 54 (45% ) had laparotomy, and 16 (14% ) had conversion from laparoscopy to laparotomy. Conservative treatment (57% of patients) was more common with laparoscopy (vs laparotomy, P < 0.05) and in women older than 44 years (vs younger than 44 years, P < 0.001). Intraoperative tumor rupture occurred in 9% of patients and was not associated with the surgical approach (P = 0.1). Bag extraction was used in 19 (40% ) of the 48 laparoscopy patients. Staging was incomplete in 73% of patients overall. By univariate analysis, better quality of staging was associated with bilateral adnexectomy, age >44 years, laparotomy, hysterectomy, and treatment after 1995. By multivariate analysis, bilateral adnexectomy or hysterectomy was associated with better staging. Mean follow-up was 40 months, during which recurrence and survival rates were similar in the laparoscopy and laparotomy groups. Conclusion. Staging of macroscopic early stage BOTs was better in patients requiring radical surgery. After adjustment on disease severity, type of surgical access was not related to staging quality.
文摘To evaluate detection rate, topography and false negatives of sentinel lymph node in endometrial cancer. Material and methods. Twenty-six patients were included. Lymphoscintigraphy was performed the day before surgery. Preoperative detection of the sentinel lymph node was performed with cervical blue dye injection and a gamma probe. Separate pathology examinations were performed for sentinel and non-sentinel lymph nodes. Sentinel lymph nodes were examined with hematoxylin-eosin-safran stain, and immunohistochemistry if negative. Results. Twenty-six patients had a positive lymphoscintigraphy. Preoperative detection was successful in 21 patients (80.8% ): the detection rate with isotopic method, 19 cases (73.1% ), was superior to the dye detection, 15 cases (57.7% ). No isolated lombo-aortic sentinel lymph nodes were observed, and all sentinel lymph nodes were in the ilio-obturator region. Seven patients presented lymphatic spread, and 4 of them had at least one sentinel node. There was one micrometastasis in sentinel node, associated with isolated tumoral cells in pelvic lymphadenectomy. There was no false negative of sentinel node. Conclusion. The biopsy of sentinel lymph node is a feasible procedure in endometrial cancer. There was one micrometastatic sentinel node. However there was no isolated lombo-aortic sentinel lymph node in this study.
