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Laparoscopic Systemic Retroperitoneal Lymphadenectomy for Women with Low-Risk Early Endometrial Cancer: A Preliminary Report
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Abstracts / Journal of Minimally Invasive Gynecology 16 (2009) S1eS51
population. The recurrence and survival times will be included in the final presentation.
136
Open Communications 7dOncology (11:18 AM d 11:23 AM)
Surgical and Survival Outcomes of Early Cervical Cancer Treated with Laparoscopic Assisted Radical Hysterectomy Wu K-Y,1 Lee C-L,1 Yen C-F,1,2 Lee P-S,1 Huang K-G.1 1Obstetrics and Gynecology, Chang Gung Memorial Hospital and University, TAo-Yuan, Taiwan, Taiwan Republic of China; 2Graduate Institue of Clinical Medical Sciences, Chang Gung University College of Medicine, TAo-Yuan, Taiwan, Taiwan Republic of China Study Objective: The aim of this study is to determine the long term results of disease-free and overall survival outcomes of laparoscopic surgery in the treatment of early stage cervical cancer. Design: longitudinal study with a series of prospectively registered patients with chart review. Setting: Tertiary referral hospital. Patients: From June 1994 to December 2005, 139 patients with early cervical cancer and no evidence of lymph node metastases in image study that underwent laparoscopic radical hysterectomy in Chang Gung Memorial Hospital were enrolled. Intervention: Laparoscopic radical hysterectomy and bilateral pelvic lymphadenectomy. Measurements and Main Results: Surgical outcomes, complications, disease-free survival and overall survival were measured. Median duration of follow up was 92.1 months (Interquartile range: 54.4, 127.4 months). The mean age was 48.1 10.2 years. The mean body mass index was 24.3 3.4 Kg/m2. 60 patients (43.2%) were FIGO Ia, 76 (54.7%) were FIGO Ib, and 3 (2.2%) were FIGO IIa, Mean operative time was 231.1 71.9 minutes. Mean blood loss was 666.0 568.8 ml. Mean of hospital stay was 8.1 3.0 days. Median number of pelvic lymph node yielded was 16. Three laparoscopic procedures were converted to laparotomy. Major intraoperative complication includes great vessel injury (3, 2.1%), ureteral injury (1, 0.7%), and colon injury (1, 0.7%). Median of follow up duration was 92.1 months (interquartile range: 54.4, 127.4). Cumulative overall survival rate was 92.78 3.06% (mean SE). Cumulative disease-free survival rate was 91.01 2.77% (mean SE). Conclusion: Laparoscopic radical hysterectomy for early cervical cancer has comparable perioperative morbidity rate and long term survival outcome. There, laparoscopic radical hysterectomy is an alternative method for treating early cervical cancer.
137
Open Communications 7dOncology (11:24 AM d 11:29 AM)
Werteim-Meigs Oncology Analyse Security: Laparocopy Versus Laparotomy Modotte WP, Gama CR, Dias R, Dias DS, Modotti CC. Po´s Graduation Program of OBG & GYN and Mastology, Faculdade de Medicina de Botucatu, Botucatu, SP, Brazil Study Objective: To evaluate the oncological security of Laparoscopic Radical Hysterectomy (LRH) through analyzes of the surgical specimen, comparing the material removed from the laparotomic approach with the one extracted from the laparoscopy, using the same surgery technique in both. Design: Prospective and randomized study. Setting: All of them had cervical cancer eith FIGO satge IA1 and IIA. Withdrawal in the two groups was made the comparison of the surgery specimens and stil changeable clinics, epidemiologists, of per and posoperative and pathological datas. Patients: Between March/2006 and May/2008, 21 submitted patients were compared Abdominal Radical Hysterectomy (ARH) with others 21 submitted LRH.
Intervention: N/A Measurements and Main Results: The pathological datas had only shown significance in the size of the tumor that was bigger in LRH group: weight of the uterus (NS), size of the tumor (S); histological type (NS); degre of diferrentiation (NS); angiolinfatica invasion (NS); invasion of parametrial (NS); invasion of the vagina (NS); number of pelvic ganglia (NS); invasion of linfods to the right (NS) and the left (NS) and type of linfonod invaded (NS). The measure of the lateral parametrical and the vaginal cuff was not significant (NS) but not to be in posterior vaginal cuff: parametrial length rigth before the tissue processing (NS) and fixed (NS), length of the parametrial lefth before the tissue processing (NS) an fixed (NS), length of anterior vaginal cuff previous the tissue processing (NS) and fixed (NS), length of posterior vaginal cuff previsu the tissue processing (S) and fixed (S). Conclusion: The surgical specimen in LRH, of the pathologic criteria, is similar to the one that of outcome in the ARH approach, suggesting that the oncological security is the same in both ways. However the LRH presents more difficulties to remove the posterior vaginal cuff.
138
Open Communications 7dOncology (11:30 AM d 11:35 AM)
Laparoscopic Systemic Retroperitoneal Lymphadenectomy for Women with Low-Risk Early Endometrial Cancer: A Preliminary Report Choi JS,1 Lee JH,1 Jung US,2 Kim SC,3 Ju W,3 Lee SR.3 1Obstetrics and Gynecology, Kangbuk Samsung Hospital, Seoul, Republic of Korea; 2 Obstetrics and Gynecology, Konyan University Hospital, Daejon, Republic of Korea; 3Obstetrics and Gynecology, Ewha Womans University Cancer Center for Women, Seoul, Republic of Korea Study Objective: To evaluate the feasibility and effectiveness of laparoscopic lymphadenectomy for low risk patients with endometrial cancer. Design: Retrospective clinical study (Canadian Task Force classification II-2). Setting: University teaching hospital. Patients: Thirty women with early endometrial cancer. Intervention: Laparoscopically assisted staging surgery. Measurements and Main Results: From January 2004 to March 2009, we reviewed the medical records of 30 patients with low risk endometrial cancer; endometrioid type, grade 1 or 2, and the depth of myometrial invasion below 1/2 of myometrium. The median age and BMI were 53.5 years (range 28e75) and 25.7 kg/m2 (range 20.4e37.2). The median operating time, estimated blood loss, and length of hospital stay were 147 minutes (range 105e410), 200 mL (range 100e700), and 7 days (range 3e19). No conversion to laparotomy was noted. The median number of harvested lymph nodes was 21.5 (range 10e48) in pelvic lymph nodes and 10 (range 4e21) in paraaortic lymph nodes. One (3.3%) patient presented pelvic lymph node metastasis and two (6.7%) presented paraaortic lymph node metastasiss on histopathological report. No vault recurrence or port site metastasis was noted until the last follow-up. Conclusion: Laproscopic pelvic and para-aortic lymphadenectomy should be considered in all low-risk patients with endometrial cancer until it is concluded to be clinically insignificant through large-scale prospective research in the future.
139
Open Communications 7dOncology (11:36 AM d 11:41 AM)
Surgical Treatment of Gynecological Malignancies in the Elderly Siesto G, Cromi A, Serati M, Zefiro F, Piazza N, Ghezzi F. Obstetrics and Gynecology, University of Insubria, Varese, Italy Study Objective: The aim of this study was to evaluate the feasibility and safety of laparoscopic surgical management of apparently early stage gynaecological malignancies in the elderly (age > 65 years).
Abstracts / Journal of Minimally Invasive Gynecology 16 (2009) S1eS51
population. The recurrence and survival times will be included in the final presentation.
136
Open Communications 7dOncology (11:18 AM d 11:23 AM)
Surgical and Survival Outcomes of Early Cervical Cancer Treated with Laparoscopic Assisted Radical Hysterectomy Wu K-Y,1 Lee C-L,1 Yen C-F,1,2 Lee P-S,1 Huang K-G.1 1Obstetrics and Gynecology, Chang Gung Memorial Hospital and University, TAo-Yuan, Taiwan, Taiwan Republic of China; 2Graduate Institue of Clinical Medical Sciences, Chang Gung University College of Medicine, TAo-Yuan, Taiwan, Taiwan Republic of China Study Objective: The aim of this study is to determine the long term results of disease-free and overall survival outcomes of laparoscopic surgery in the treatment of early stage cervical cancer. Design: longitudinal study with a series of prospectively registered patients with chart review. Setting: Tertiary referral hospital. Patients: From June 1994 to December 2005, 139 patients with early cervical cancer and no evidence of lymph node metastases in image study that underwent laparoscopic radical hysterectomy in Chang Gung Memorial Hospital were enrolled. Intervention: Laparoscopic radical hysterectomy and bilateral pelvic lymphadenectomy. Measurements and Main Results: Surgical outcomes, complications, disease-free survival and overall survival were measured. Median duration of follow up was 92.1 months (Interquartile range: 54.4, 127.4 months). The mean age was 48.1 10.2 years. The mean body mass index was 24.3 3.4 Kg/m2. 60 patients (43.2%) were FIGO Ia, 76 (54.7%) were FIGO Ib, and 3 (2.2%) were FIGO IIa, Mean operative time was 231.1 71.9 minutes. Mean blood loss was 666.0 568.8 ml. Mean of hospital stay was 8.1 3.0 days. Median number of pelvic lymph node yielded was 16. Three laparoscopic procedures were converted to laparotomy. Major intraoperative complication includes great vessel injury (3, 2.1%), ureteral injury (1, 0.7%), and colon injury (1, 0.7%). Median of follow up duration was 92.1 months (interquartile range: 54.4, 127.4). Cumulative overall survival rate was 92.78 3.06% (mean SE). Cumulative disease-free survival rate was 91.01 2.77% (mean SE). Conclusion: Laparoscopic radical hysterectomy for early cervical cancer has comparable perioperative morbidity rate and long term survival outcome. There, laparoscopic radical hysterectomy is an alternative method for treating early cervical cancer.
137
Open Communications 7dOncology (11:24 AM d 11:29 AM)
Werteim-Meigs Oncology Analyse Security: Laparocopy Versus Laparotomy Modotte WP, Gama CR, Dias R, Dias DS, Modotti CC. Po´s Graduation Program of OBG & GYN and Mastology, Faculdade de Medicina de Botucatu, Botucatu, SP, Brazil Study Objective: To evaluate the oncological security of Laparoscopic Radical Hysterectomy (LRH) through analyzes of the surgical specimen, comparing the material removed from the laparotomic approach with the one extracted from the laparoscopy, using the same surgery technique in both. Design: Prospective and randomized study. Setting: All of them had cervical cancer eith FIGO satge IA1 and IIA. Withdrawal in the two groups was made the comparison of the surgery specimens and stil changeable clinics, epidemiologists, of per and posoperative and pathological datas. Patients: Between March/2006 and May/2008, 21 submitted patients were compared Abdominal Radical Hysterectomy (ARH) with others 21 submitted LRH.
Intervention: N/A Measurements and Main Results: The pathological datas had only shown significance in the size of the tumor that was bigger in LRH group: weight of the uterus (NS), size of the tumor (S); histological type (NS); degre of diferrentiation (NS); angiolinfatica invasion (NS); invasion of parametrial (NS); invasion of the vagina (NS); number of pelvic ganglia (NS); invasion of linfods to the right (NS) and the left (NS) and type of linfonod invaded (NS). The measure of the lateral parametrical and the vaginal cuff was not significant (NS) but not to be in posterior vaginal cuff: parametrial length rigth before the tissue processing (NS) and fixed (NS), length of the parametrial lefth before the tissue processing (NS) an fixed (NS), length of anterior vaginal cuff previous the tissue processing (NS) and fixed (NS), length of posterior vaginal cuff previsu the tissue processing (S) and fixed (S). Conclusion: The surgical specimen in LRH, of the pathologic criteria, is similar to the one that of outcome in the ARH approach, suggesting that the oncological security is the same in both ways. However the LRH presents more difficulties to remove the posterior vaginal cuff.
138
Open Communications 7dOncology (11:30 AM d 11:35 AM)
Laparoscopic Systemic Retroperitoneal Lymphadenectomy for Women with Low-Risk Early Endometrial Cancer: A Preliminary Report Choi JS,1 Lee JH,1 Jung US,2 Kim SC,3 Ju W,3 Lee SR.3 1Obstetrics and Gynecology, Kangbuk Samsung Hospital, Seoul, Republic of Korea; 2 Obstetrics and Gynecology, Konyan University Hospital, Daejon, Republic of Korea; 3Obstetrics and Gynecology, Ewha Womans University Cancer Center for Women, Seoul, Republic of Korea Study Objective: To evaluate the feasibility and effectiveness of laparoscopic lymphadenectomy for low risk patients with endometrial cancer. Design: Retrospective clinical study (Canadian Task Force classification II-2). Setting: University teaching hospital. Patients: Thirty women with early endometrial cancer. Intervention: Laparoscopically assisted staging surgery. Measurements and Main Results: From January 2004 to March 2009, we reviewed the medical records of 30 patients with low risk endometrial cancer; endometrioid type, grade 1 or 2, and the depth of myometrial invasion below 1/2 of myometrium. The median age and BMI were 53.5 years (range 28e75) and 25.7 kg/m2 (range 20.4e37.2). The median operating time, estimated blood loss, and length of hospital stay were 147 minutes (range 105e410), 200 mL (range 100e700), and 7 days (range 3e19). No conversion to laparotomy was noted. The median number of harvested lymph nodes was 21.5 (range 10e48) in pelvic lymph nodes and 10 (range 4e21) in paraaortic lymph nodes. One (3.3%) patient presented pelvic lymph node metastasis and two (6.7%) presented paraaortic lymph node metastasiss on histopathological report. No vault recurrence or port site metastasis was noted until the last follow-up. Conclusion: Laproscopic pelvic and para-aortic lymphadenectomy should be considered in all low-risk patients with endometrial cancer until it is concluded to be clinically insignificant through large-scale prospective research in the future.
139
Open Communications 7dOncology (11:36 AM d 11:41 AM)
Surgical Treatment of Gynecological Malignancies in the Elderly Siesto G, Cromi A, Serati M, Zefiro F, Piazza N, Ghezzi F. Obstetrics and Gynecology, University of Insubria, Varese, Italy Study Objective: The aim of this study was to evaluate the feasibility and safety of laparoscopic surgical management of apparently early stage gynaecological malignancies in the elderly (age > 65 years).