Surgery for patients with endometrioid-type endometrial cancer: is lymphadenectomy above the inferior mesenteric artery necessary?
Abstract Objective The primary objective of this study was to identify the risk of metastasis to lymph nodes above the inferior mesenteric artery (IMA) in endometrioid-type endometrial cancer (EC) and the factors that influence metastasis. Methods The study included patients who had been operated on...
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BMC
2024-12-01
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| Series: | World Journal of Surgical Oncology |
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| Online Access: | https://doi.org/10.1186/s12957-024-03628-7 |
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| author | Abdurrahman Alp Tokalioglu Okan Oktar Mehmet Unsal Okan Aytekin Baran Yesil Huseyin Altas Ayse Buran Yesim Ucar Dilek Yuksel Gunsu Kimyon Comert Burak Ersak Fatih Kilic Cigdem Kilic Caner Cakır Sevgi Koc Ozlem Moraloglu Tekin Yaprak Ustun Taner Turan |
| author_facet | Abdurrahman Alp Tokalioglu Okan Oktar Mehmet Unsal Okan Aytekin Baran Yesil Huseyin Altas Ayse Buran Yesim Ucar Dilek Yuksel Gunsu Kimyon Comert Burak Ersak Fatih Kilic Cigdem Kilic Caner Cakır Sevgi Koc Ozlem Moraloglu Tekin Yaprak Ustun Taner Turan |
| author_sort | Abdurrahman Alp Tokalioglu |
| collection | DOAJ |
| description | Abstract Objective The primary objective of this study was to identify the risk of metastasis to lymph nodes above the inferior mesenteric artery (IMA) in endometrioid-type endometrial cancer (EC) and the factors that influence metastasis. Methods The study included patients who had been operated on for endometrioid-type EC in three gynecological oncology centers between 2007 and 2023. The supramesenteric lymph node (SM-LN) is the region between the left renal vein and the IMA, whereas the inframesenteric lymph node (IM-LN) is the region between the IMA and the aortic bifurcation, as determined by the level of the IMA. Results The study sample comprised 412 patients. The median number of lymph nodes excised per patient was 58. The median count was 37 for pelvic lymph nodes, 21 for para-aortic lymph nodes, 8 for IM-LN, and 13 for SM-LN. In the univariate analysis, the factors that were found to be statistically significant in determining SM-LN metastasis included tumor size, depth of myometrial invasion, uterine serosal invasion, lymphovascular space invasion (LVSI), cervical invasion, peritoneal cytology, adnexal metastasis, omental metastasis, non-nodal extrauterine metastasis, pelvic lymph node metastasis, and IM-LN metastasis. In the multivariate analysis, SM-LN metastasis was independently associated with tumor size, LVSI, pelvic lymph node metastasis, and IM-LN metastasis. Conclusion In conclusion, in cases of intermediate-high risk EC, it is important to know that the disease spreads to SM-LN in 7.3% of patients. The efficacy of postoperative adjuvant treatment may be inadequate due to a lack of information regarding the SM-LN region. |
| format | Article |
| id | doaj-art-efbc5cf708294cc39fbef4adeb991a96 |
| institution | DOAJ |
| issn | 1477-7819 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj-art-efbc5cf708294cc39fbef4adeb991a962025-08-20T02:39:49ZengBMCWorld Journal of Surgical Oncology1477-78192024-12-012211810.1186/s12957-024-03628-7Surgery for patients with endometrioid-type endometrial cancer: is lymphadenectomy above the inferior mesenteric artery necessary?Abdurrahman Alp Tokalioglu0Okan Oktar1Mehmet Unsal2Okan Aytekin3Baran Yesil4Huseyin Altas5Ayse Buran6Yesim Ucar7Dilek Yuksel8Gunsu Kimyon Comert9Burak Ersak10Fatih Kilic11Cigdem Kilic12Caner Cakır13Sevgi Koc14Ozlem Moraloglu Tekin15Yaprak Ustun16Taner Turan17Department of Gynecologic Oncology, Ankara Bilkent City Hospital, Faculty of Medicine, University of Health SciencesDepartment of Gynecologic Oncology, Ankara Etlik City Hospital, Faculty of Medicine, University of Health SciencesDepartment of Gynecologic Oncology, Ankara Bilkent City Hospital, Faculty of Medicine, University of Health SciencesDepartment of Gynecologic Oncology, Ankara Bilkent City Hospital, Faculty of Medicine, University of Health SciencesDepartment of Gynecologic Oncology, Ankara Etlik City Hospital, Faculty of Medicine, University of Health SciencesDepartment of Gynecologic Oncology, Ankara Bilkent City Hospital, Faculty of Medicine, University of Health SciencesDepartment of Gynecologic Oncology, Ankara Bilkent City Hospital, Faculty of Medicine, University of Health SciencesDepartment of Gynecologic Oncology, Ankara Bilkent City Hospital, Faculty of Medicine, University of Health SciencesDepartment of Gynecologic Oncology, Ankara Etlik City Hospital, Faculty of Medicine, University of Health SciencesDepartment of Gynecologic Oncology, Ankara Bilkent City Hospital, Faculty of Medicine, University of Health SciencesDepartment of Gynecologic Oncology, Ankara Etlik City Hospital, Faculty of Medicine, University of Health SciencesDepartment of Gynecologic Oncology, Ankara Bilkent City Hospital, Faculty of Medicine, University of Health SciencesDepartment of Gynecologic Oncology, Faculty of Medicine, Etlik Zubeyde Hanim Women’s Health Training and Research Hospital, University of Health SciencesDepartment of Gynecologic Oncology, Ankara Etlik City Hospital, Faculty of Medicine, University of Health SciencesDepartment of Gynecologic Oncology, Faculty of Medicine, Etlik Zubeyde Hanim Women’s Health Training and Research Hospital, University of Health SciencesDepartment of Obstetrics and Gynecology, Ankara Bilkent City Hospital, Faculty of Medicine, University of Health SciencesDepartment of Obstetrics and Gynecology, Faculty of Medicine, Etlik Zubeyde Hanim Women’s Health Training and Research Hospital, University of Health SciencesDepartment of Gynecologic Oncology, Ankara Bilkent City Hospital, Faculty of Medicine, University of Health SciencesAbstract Objective The primary objective of this study was to identify the risk of metastasis to lymph nodes above the inferior mesenteric artery (IMA) in endometrioid-type endometrial cancer (EC) and the factors that influence metastasis. Methods The study included patients who had been operated on for endometrioid-type EC in three gynecological oncology centers between 2007 and 2023. The supramesenteric lymph node (SM-LN) is the region between the left renal vein and the IMA, whereas the inframesenteric lymph node (IM-LN) is the region between the IMA and the aortic bifurcation, as determined by the level of the IMA. Results The study sample comprised 412 patients. The median number of lymph nodes excised per patient was 58. The median count was 37 for pelvic lymph nodes, 21 for para-aortic lymph nodes, 8 for IM-LN, and 13 for SM-LN. In the univariate analysis, the factors that were found to be statistically significant in determining SM-LN metastasis included tumor size, depth of myometrial invasion, uterine serosal invasion, lymphovascular space invasion (LVSI), cervical invasion, peritoneal cytology, adnexal metastasis, omental metastasis, non-nodal extrauterine metastasis, pelvic lymph node metastasis, and IM-LN metastasis. In the multivariate analysis, SM-LN metastasis was independently associated with tumor size, LVSI, pelvic lymph node metastasis, and IM-LN metastasis. Conclusion In conclusion, in cases of intermediate-high risk EC, it is important to know that the disease spreads to SM-LN in 7.3% of patients. The efficacy of postoperative adjuvant treatment may be inadequate due to a lack of information regarding the SM-LN region.https://doi.org/10.1186/s12957-024-03628-7Endometrial CancerInferior Mesenteric ArteryLymph Node Metastasis |
| spellingShingle | Abdurrahman Alp Tokalioglu Okan Oktar Mehmet Unsal Okan Aytekin Baran Yesil Huseyin Altas Ayse Buran Yesim Ucar Dilek Yuksel Gunsu Kimyon Comert Burak Ersak Fatih Kilic Cigdem Kilic Caner Cakır Sevgi Koc Ozlem Moraloglu Tekin Yaprak Ustun Taner Turan Surgery for patients with endometrioid-type endometrial cancer: is lymphadenectomy above the inferior mesenteric artery necessary? World Journal of Surgical Oncology Endometrial Cancer Inferior Mesenteric Artery Lymph Node Metastasis |
| title | Surgery for patients with endometrioid-type endometrial cancer: is lymphadenectomy above the inferior mesenteric artery necessary? |
| title_full | Surgery for patients with endometrioid-type endometrial cancer: is lymphadenectomy above the inferior mesenteric artery necessary? |
| title_fullStr | Surgery for patients with endometrioid-type endometrial cancer: is lymphadenectomy above the inferior mesenteric artery necessary? |
| title_full_unstemmed | Surgery for patients with endometrioid-type endometrial cancer: is lymphadenectomy above the inferior mesenteric artery necessary? |
| title_short | Surgery for patients with endometrioid-type endometrial cancer: is lymphadenectomy above the inferior mesenteric artery necessary? |
| title_sort | surgery for patients with endometrioid type endometrial cancer is lymphadenectomy above the inferior mesenteric artery necessary |
| topic | Endometrial Cancer Inferior Mesenteric Artery Lymph Node Metastasis |
| url | https://doi.org/10.1186/s12957-024-03628-7 |
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