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Erschienen in: Archives of Gynecology and Obstetrics 2/2009

01.08.2009 | Original Article

Do routine preoperative imaging techniques facilitate the operation in endometrial cancer?

verfasst von: N. Cenk Sayın, Füsun G. Varol, M. Ali Yüce, Petek Kaplan, Nefize Ahmet, Necdet Süt, Fatih Güçer

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 2/2009

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Abstract

Objective

To assess the role of routine intravenous pyelography (IVP), rectoscopy and additional imaging techniques like computed tomography (CT) and abdominal ultrasonography (USG) for the evaluation of patients with endometrial cancer.

Materials and methods

A total of 97 women with endometrial cancer (82 endometrioid and 15 non-endometrioid type) of all stages (Stage I = 65, II = 14, III = 13, IV = 5) were included in the study. Of these, 50 women were admitted because of postmenopausal bleeding, 24 with irregular vaginal bleeding and 7 with pain and leucorrhea, whereas the others had no complaints. Only one patient had symptoms related to the gastrointestinal system, but none for the urinary system. Preoperative CT (n = 45), IVP (n = 78), rectoscopy (n = 46), and USG or colonoscopy (n = 37) were performed on our patients. All the women had total abdominal hysterectomy and bilateral salpingo-oophorectomy, with/without pelvic (n = 81) and paraaortic (n = 34) lymphonodectomy, and omentectomy (n = 35).

Results

In 39 of 45 women who had CT, it had no effect on the operation and did not facilitate the operation. In two women there were pathological findings on CT and some interventions (resection and anastomosis) were performed on the gastrointestinal tract in these patients. However, CT had overcome pathological findings related with the gastrointestinal or urinary systems in four women, who needed interventions to these systems during the operation. CT was not performed on six women who needed interventions to the gastrointestinal system during the operations. Three patients had pathological findings (fissure, external compression) in rectoscopy, but only one patient had ileo-transverstomy, in which rectoscopic finding had not predicted the necessity of that procedure. Out of 78 IVP, the only finding was external compression to the bladder in 38 patients, and this finding had no contribution to the operation. Among women who had USG or colonoscopy (n = 37) performed, five had pathological findings that contributed to the extensiveness or the mode of the operations (liver nodules, polyps in the colon).

Conclusions

Routine preoperative computed tomography, intravenous pyelography, rectoscopy or abdominal USG and colonoscopy have little impact on the decision and the prediction of the extensiveness of the operation.
Literatur
1.
Zurück zum Zitat Creasman WT, Morrow CP, Bundy BN, Homesley HD, Graham JE, Heller PB (1987) Surgical pathologic spread patterns of endometrial cancer (a Gynecol Oncol Group study). Cancer 60(8):2035–2041. doi:10.1002/1097-0142(19901015)60:8+<2035::AID-CNCR2820601515>3.0.CO;2-8PubMedCrossRef Creasman WT, Morrow CP, Bundy BN, Homesley HD, Graham JE, Heller PB (1987) Surgical pathologic spread patterns of endometrial cancer (a Gynecol Oncol Group study). Cancer 60(8):2035–2041. doi:10.1002/1097-0142(19901015)60:8+<2035::AID-CNCR2820601515>3.0.CO;2-8PubMedCrossRef
2.
Zurück zum Zitat Ascher SM, Cooper C, Scoutt L, Imaoka I, Hricak H (2005) Diagnostic imaging techniques in gynecologic oncology. In: Hoskins WJ, Perez CA, Young RC (eds) Principles of gynecologic oncology. Williams & Wilkins, Philadelphia, pp 223–268 Ascher SM, Cooper C, Scoutt L, Imaoka I, Hricak H (2005) Diagnostic imaging techniques in gynecologic oncology. In: Hoskins WJ, Perez CA, Young RC (eds) Principles of gynecologic oncology. Williams & Wilkins, Philadelphia, pp 223–268
3.
Zurück zum Zitat Anderson B (1986) Diagnosis of endometrial cancer. Clin Obstet Gynaecol 13(4):739–750PubMed Anderson B (1986) Diagnosis of endometrial cancer. Clin Obstet Gynaecol 13(4):739–750PubMed
4.
Zurück zum Zitat Kirby TO, Leath CA 3rd, Kilgore LC (2006) Surgical staging in endometrial cancer. Oncology 20(1):45–50 Williston ParkPubMed Kirby TO, Leath CA 3rd, Kilgore LC (2006) Surgical staging in endometrial cancer. Oncology 20(1):45–50 Williston ParkPubMed
5.
Zurück zum Zitat Shepherd JH (1989) Revised FIGO staging for gynaecological cancer. Br J Obstet Gynaecol 96(8):889–892PubMed Shepherd JH (1989) Revised FIGO staging for gynaecological cancer. Br J Obstet Gynaecol 96(8):889–892PubMed
6.
Zurück zum Zitat Rockall AG, Sohaib SA, Harisinghani MG et al (2005) Diagnostic performance of nanoparticle-enhanced magnetic resonance imaging in the diagnosis of lymph node metastases in patients with endometrial and cervical cancer. J Clin Oncol 23(12):2813–2821. doi:10.1200/JCO.2005.07.166 PubMedCrossRef Rockall AG, Sohaib SA, Harisinghani MG et al (2005) Diagnostic performance of nanoparticle-enhanced magnetic resonance imaging in the diagnosis of lymph node metastases in patients with endometrial and cervical cancer. J Clin Oncol 23(12):2813–2821. doi:10.​1200/​JCO.​2005.​07.​166 PubMedCrossRef
7.
Zurück zum Zitat Zerbe MJ, Bristow R, Grumbine FC, Montz FJ (2000) Inability of preoperative computed tomography scans to accurately predict the extent of myometrial invasion and extracorporal spread in endometrial cancer. Gynecol Oncol 78(1):67–70. doi:10.1006/gyno.2000.5820 PubMedCrossRef Zerbe MJ, Bristow R, Grumbine FC, Montz FJ (2000) Inability of preoperative computed tomography scans to accurately predict the extent of myometrial invasion and extracorporal spread in endometrial cancer. Gynecol Oncol 78(1):67–70. doi:10.​1006/​gyno.​2000.​5820 PubMedCrossRef
9.
Zurück zum Zitat Vorgias G, Katsoulis M, Argyrou K et al (2002) Preoperative imaging of primary intra-abdominal gynaecological malignancies, diagnostic accuracy of CT-scan and MRI. a Greek cohort study. Eur J Gynaecol Oncol 23(2):139–144PubMed Vorgias G, Katsoulis M, Argyrou K et al (2002) Preoperative imaging of primary intra-abdominal gynaecological malignancies, diagnostic accuracy of CT-scan and MRI. a Greek cohort study. Eur J Gynaecol Oncol 23(2):139–144PubMed
11.
Zurück zum Zitat Park JY, Kim EN, Kim DY et al (2008) Comparison of the validity of magnetic resonance imaging and positron emission tomography/computed tomography in the preoperative evaluation of patients with uterine corpus cancer. Gynecol Oncol 108:486–492. doi:10.1016/j.ygyno.2007.11.044 PubMedCrossRef Park JY, Kim EN, Kim DY et al (2008) Comparison of the validity of magnetic resonance imaging and positron emission tomography/computed tomography in the preoperative evaluation of patients with uterine corpus cancer. Gynecol Oncol 108:486–492. doi:10.​1016/​j.​ygyno.​2007.​11.​044 PubMedCrossRef
13.
Zurück zum Zitat Sironi S, Picchio M, Landoni C et al (2007) Post-therapy surveillance of patients with uterine cancers: value of integrated FDG PET/CT in the detection of recurrence. Eur J Nucl Med Mol Imaging 34:472–479. doi:10.1007/s00259-006-0251-y PubMedCrossRef Sironi S, Picchio M, Landoni C et al (2007) Post-therapy surveillance of patients with uterine cancers: value of integrated FDG PET/CT in the detection of recurrence. Eur J Nucl Med Mol Imaging 34:472–479. doi:10.​1007/​s00259-006-0251-y PubMedCrossRef
14.
Zurück zum Zitat Benedetti-Panici P, Maneschi F, Scambia G, Greggi S, Mancuso S (1994) Anatomic abnormalities of the retroperitoneum encountered during aortic and pelvic lymphadenectomy. Am J Obstet Gynecol 170(1 Pt 1):111–116PubMed Benedetti-Panici P, Maneschi F, Scambia G, Greggi S, Mancuso S (1994) Anatomic abnormalities of the retroperitoneum encountered during aortic and pelvic lymphadenectomy. Am J Obstet Gynecol 170(1 Pt 1):111–116PubMed
15.
Zurück zum Zitat Chung HH, Kim JW, Park NH, Song YS, Kang SB, Lee HP (2006) Use of preoperative serum CA-125 levels for prediction of lymph node metastasis and prognosis in endometrial cancer. Acta Obstet Gynecol Scand 85:1501–1505PubMedCrossRef Chung HH, Kim JW, Park NH, Song YS, Kang SB, Lee HP (2006) Use of preoperative serum CA-125 levels for prediction of lymph node metastasis and prognosis in endometrial cancer. Acta Obstet Gynecol Scand 85:1501–1505PubMedCrossRef
16.
18.
19.
Zurück zum Zitat Trope CG, Alektiar KM, Sabbatini PJ, Zaino RJ (2005) Corpus: epithelial tumors. In: Hoskins WJ, Perez CA, Young RC (eds) Principles of gynecologic oncology. Williams & Wilkins, Philadelphia, pp 823–872 Trope CG, Alektiar KM, Sabbatini PJ, Zaino RJ (2005) Corpus: epithelial tumors. In: Hoskins WJ, Perez CA, Young RC (eds) Principles of gynecologic oncology. Williams & Wilkins, Philadelphia, pp 823–872
Metadaten
Titel
Do routine preoperative imaging techniques facilitate the operation in endometrial cancer?
verfasst von
N. Cenk Sayın
Füsun G. Varol
M. Ali Yüce
Petek Kaplan
Nefize Ahmet
Necdet Süt
Fatih Güçer
Publikationsdatum
01.08.2009
Verlag
Springer-Verlag
Erschienen in
Archives of Gynecology and Obstetrics / Ausgabe 2/2009
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-008-0893-z

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