What is the incidence of isolated paraaortic nodal recurrence in grade 1 endometrial carcinoma? Journal Article
| Authors: | Abu-Rustum, N. R.; Chi, D. S.; Leitao, M.; Oke, E. A.; Hensley, M. L.; Alektiar, K. M.; Barakat, R. R. |
| Article Title: | What is the incidence of isolated paraaortic nodal recurrence in grade 1 endometrial carcinoma? |
| Abstract: | Objectives: To describe the incidence of isolated paraaortic nodal recurrences in patients with a final diagnosis of grade 1 endometrial carcinoma initially treated with surgery. Methods: Records from a prospectively maintained endometrial carcinoma database were reviewed to identify sites of recurrence. Patients with any papillary serous or clear cell carcinoma, leiomyosarcoma, endometrial stromal sarcoma, squamous carcinoma, or adenosarcoma were excluded. Recurrence sites were classified into 4 main categories: 1) pelvic (including vaginal and other soft tissue pelvic sites); 2) abdominal (including peritoneum, omentum and liver); 3) distant (including lung, brain, supraclavicular, and groins); and 4) isolated paraaortic nodal recurrence (including any nodal recurrence between the midcommon iliac to renal vessels). Results: Between 1/93 and 5/06, 1453 patients with endometrial carcinoma met the study inclusion criteria. Final grade distribution included: grade 1 endometrial adenocarcinoma, 310 (21%); grade 2, 578 (40%); grade 3, 481 (33%); and incomplete, 84 (5.8%). In all, 154 patients (11%) had documented recurrences. Recurrence sites for all patients/all grades included: pelvis, 52 (34%); abdomen, 51 (33%); distant, 41 (27%), and isolated paraaortic, 10 (6%). None of the isolated paraaortic recurrences occurred in patients with a final diagnosis of grade 1 carcinoma. Furthermore, 9/10 (90%) isolated paraaortic nodal recurrences were in grade 3 tumors. Only 8 (2.6%) of 310 patients with grade 1 tumors recurred. Sites of recurrence for grade 1 tumors included: abdomen, 3; pelvis, 3; and distant, 2. Conclusions: This large series of endometrial carcinoma patients initially treated with surgery confirms that isolated paraaortic nodal recurrence in women with a final diagnosis of grade 1 endometrial carcinoma is extremely rare. These rare isolated paraaortic nodal recurrences appear to be limited to high-grade endometrial carcinomas. © 2008 Elsevier Inc. All rights reserved. |
| Keywords: | adult; controlled study; aged; aged, 80 and over; middle aged; cancer surgery; major clinical study; cancer localization; patient selection; united states; recurrent cancer; endometrial cancer; lymph node metastasis; paraaortic nodes; staging; endometrium carcinoma; paraaortic lymph node; endometrial neoplasms; lymph nodes; lymphatic metastasis; neoplasm staging; pelvis; cancer grading; lymph node excision; metastasis; neoplasm recurrence, local; vagina; incidence; data base; distant metastasis; soft tissue; liver metastasis; lung metastasis; abdomen; medical record; brain metastasis; peritoneum metastasis; ileum; omentum; inguinal region; recurrent endometrial cancer; kidney blood vessel |
| Journal Title: | Gynecologic Oncology |
| Volume: | 111 |
| Issue: | 1 |
| ISSN: | 0090-8258 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2008-10-01 |
| Start Page: | 46 |
| End Page: | 48 |
| Language: | English |
| DOI: | 10.1016/j.ygyno.2008.06.010 |
| PUBMED: | 18657853 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 7" - "Export Date: 17 November 2011" - "CODEN: GYNOA" - "Source: Scopus" |
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