Distribution and volume of extrauterine disease in uterine serous carcinoma is minimally invasive surgery a suitable approach?

Tina A. Ayeni, Mariam M. Alhilli, Jamie N Bakkum-Gamez, Andrea Mariani, Michaela E. McGree, Amy L. Weaver, William Arthur Cliby, Gary Keeney, Karl C. Podratz, Sean Christopher Dowdy

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective: Minimally invasive surgery (MIS) is the preferred technique for managing endometrial cancer. Given that uterine serous carcinoma (USC) has a predilection for multiquadrant peritoneal dissemination, our objective was to estimate the potential risk for overlooking occult peritoneal spread with the use of MIS. Methods: A single-institution, retrospective review was conducted of patients who underwent primary surgical staging for endometrial cancer via laparotomy between 1999 and 2008. Patterns of metastases were analyzed to estimate the potential risk for understaging via MIS. Results: A total of 202 USC cases met inclusion criteria. Pelvic and para-aortic nodes were positive in 59 (36%) of 166 and 43 (31%) of 138, respectively. Stage IVb disease was diagnosed in 77 (38%) of 202 patients. The majority (86%, 66/77) harbored bulky and/or multisite macroscopic abdominal implants. Isolated microscopic peritoneal disease was present in 5 of 77 cases (6% of stage IV, 2%of the entire cohort) but, in all cases, was limited to the omentum; 6 of 77 cases (8% of stage IV, 3%of the cohort) harbored a single implant in the context of a negative omentum but, in all cases, were macroscopic (locations included the ileum, the diaphragm, and the base of the mesentery). Conclusions: For providers who aim to remove all visible disease in patients with USC, the rate of extrauterine disease escaping detection using MIS is low (G3%) provided an omentectomy is performed together with staging.

Original languageEnglish (US)
Pages (from-to)87-91
Number of pages5
JournalInternational Journal of Gynecological Cancer
Volume25
Issue number1
DOIs
StatePublished - Oct 8 2014

Fingerprint

Uterine Diseases
Minimally Invasive Surgical Procedures
Carcinoma
Omentum
Endometrial Neoplasms
Peritoneal Diseases
Mesentery
Diaphragm
Ileum
Laparotomy
Neoplasm Metastasis

Keywords

  • Endometrial cancer
  • Minimally invasive surgery
  • Uterine serous carcinoma

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

Cite this

Distribution and volume of extrauterine disease in uterine serous carcinoma is minimally invasive surgery a suitable approach? / Ayeni, Tina A.; Alhilli, Mariam M.; Bakkum-Gamez, Jamie N; Mariani, Andrea; McGree, Michaela E.; Weaver, Amy L.; Cliby, William Arthur; Keeney, Gary; Podratz, Karl C.; Dowdy, Sean Christopher.

In: International Journal of Gynecological Cancer, Vol. 25, No. 1, 08.10.2014, p. 87-91.

Research output: Contribution to journalArticle

@article{47b62668849f4c6299f9f1005c6ea200,
title = "Distribution and volume of extrauterine disease in uterine serous carcinoma is minimally invasive surgery a suitable approach?",
abstract = "Objective: Minimally invasive surgery (MIS) is the preferred technique for managing endometrial cancer. Given that uterine serous carcinoma (USC) has a predilection for multiquadrant peritoneal dissemination, our objective was to estimate the potential risk for overlooking occult peritoneal spread with the use of MIS. Methods: A single-institution, retrospective review was conducted of patients who underwent primary surgical staging for endometrial cancer via laparotomy between 1999 and 2008. Patterns of metastases were analyzed to estimate the potential risk for understaging via MIS. Results: A total of 202 USC cases met inclusion criteria. Pelvic and para-aortic nodes were positive in 59 (36{\%}) of 166 and 43 (31{\%}) of 138, respectively. Stage IVb disease was diagnosed in 77 (38{\%}) of 202 patients. The majority (86{\%}, 66/77) harbored bulky and/or multisite macroscopic abdominal implants. Isolated microscopic peritoneal disease was present in 5 of 77 cases (6{\%} of stage IV, 2{\%}of the entire cohort) but, in all cases, was limited to the omentum; 6 of 77 cases (8{\%} of stage IV, 3{\%}of the cohort) harbored a single implant in the context of a negative omentum but, in all cases, were macroscopic (locations included the ileum, the diaphragm, and the base of the mesentery). Conclusions: For providers who aim to remove all visible disease in patients with USC, the rate of extrauterine disease escaping detection using MIS is low (G3{\%}) provided an omentectomy is performed together with staging.",
keywords = "Endometrial cancer, Minimally invasive surgery, Uterine serous carcinoma",
author = "Ayeni, {Tina A.} and Alhilli, {Mariam M.} and Bakkum-Gamez, {Jamie N} and Andrea Mariani and McGree, {Michaela E.} and Weaver, {Amy L.} and Cliby, {William Arthur} and Gary Keeney and Podratz, {Karl C.} and Dowdy, {Sean Christopher}",
year = "2014",
month = "10",
day = "8",
doi = "10.1097/IGC.0000000000000326",
language = "English (US)",
volume = "25",
pages = "87--91",
journal = "International Journal of Gynecological Cancer",
issn = "1048-891X",
publisher = "Wolters Kluwer Health",
number = "1",

}

TY - JOUR

T1 - Distribution and volume of extrauterine disease in uterine serous carcinoma is minimally invasive surgery a suitable approach?

AU - Ayeni, Tina A.

AU - Alhilli, Mariam M.

AU - Bakkum-Gamez, Jamie N

AU - Mariani, Andrea

AU - McGree, Michaela E.

AU - Weaver, Amy L.

AU - Cliby, William Arthur

AU - Keeney, Gary

AU - Podratz, Karl C.

AU - Dowdy, Sean Christopher

PY - 2014/10/8

Y1 - 2014/10/8

N2 - Objective: Minimally invasive surgery (MIS) is the preferred technique for managing endometrial cancer. Given that uterine serous carcinoma (USC) has a predilection for multiquadrant peritoneal dissemination, our objective was to estimate the potential risk for overlooking occult peritoneal spread with the use of MIS. Methods: A single-institution, retrospective review was conducted of patients who underwent primary surgical staging for endometrial cancer via laparotomy between 1999 and 2008. Patterns of metastases were analyzed to estimate the potential risk for understaging via MIS. Results: A total of 202 USC cases met inclusion criteria. Pelvic and para-aortic nodes were positive in 59 (36%) of 166 and 43 (31%) of 138, respectively. Stage IVb disease was diagnosed in 77 (38%) of 202 patients. The majority (86%, 66/77) harbored bulky and/or multisite macroscopic abdominal implants. Isolated microscopic peritoneal disease was present in 5 of 77 cases (6% of stage IV, 2%of the entire cohort) but, in all cases, was limited to the omentum; 6 of 77 cases (8% of stage IV, 3%of the cohort) harbored a single implant in the context of a negative omentum but, in all cases, were macroscopic (locations included the ileum, the diaphragm, and the base of the mesentery). Conclusions: For providers who aim to remove all visible disease in patients with USC, the rate of extrauterine disease escaping detection using MIS is low (G3%) provided an omentectomy is performed together with staging.

AB - Objective: Minimally invasive surgery (MIS) is the preferred technique for managing endometrial cancer. Given that uterine serous carcinoma (USC) has a predilection for multiquadrant peritoneal dissemination, our objective was to estimate the potential risk for overlooking occult peritoneal spread with the use of MIS. Methods: A single-institution, retrospective review was conducted of patients who underwent primary surgical staging for endometrial cancer via laparotomy between 1999 and 2008. Patterns of metastases were analyzed to estimate the potential risk for understaging via MIS. Results: A total of 202 USC cases met inclusion criteria. Pelvic and para-aortic nodes were positive in 59 (36%) of 166 and 43 (31%) of 138, respectively. Stage IVb disease was diagnosed in 77 (38%) of 202 patients. The majority (86%, 66/77) harbored bulky and/or multisite macroscopic abdominal implants. Isolated microscopic peritoneal disease was present in 5 of 77 cases (6% of stage IV, 2%of the entire cohort) but, in all cases, was limited to the omentum; 6 of 77 cases (8% of stage IV, 3%of the cohort) harbored a single implant in the context of a negative omentum but, in all cases, were macroscopic (locations included the ileum, the diaphragm, and the base of the mesentery). Conclusions: For providers who aim to remove all visible disease in patients with USC, the rate of extrauterine disease escaping detection using MIS is low (G3%) provided an omentectomy is performed together with staging.

KW - Endometrial cancer

KW - Minimally invasive surgery

KW - Uterine serous carcinoma

UR - http://www.scopus.com/inward/record.url?scp=84927740168&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84927740168&partnerID=8YFLogxK

U2 - 10.1097/IGC.0000000000000326

DO - 10.1097/IGC.0000000000000326

M3 - Article

C2 - 25474625

AN - SCOPUS:84927740168

VL - 25

SP - 87

EP - 91

JO - International Journal of Gynecological Cancer

JF - International Journal of Gynecological Cancer

SN - 1048-891X

IS - 1

ER -