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ENDOMETRIAL CANCER: SURGICAL STAGING

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Author(s): Daniel da Silva

Journal: Acta Obstetrica e Ginecologia Portuguesa
ISSN 1646-5830


ABSTRACT
Endometrial cancer is the most common genital tract malignancy in western countries. The long-term survival of patients with endometrial cancer is related to the stage at diagnosis. In 1988, FIGO (International Federation of Gynaecology and Obstetrics) recognized the limitations of clinical assessment of disease extent and recommended a surgical staging process. This staging requirement raised numerous controversies around the importance of determining nodal status and its impact on outcomes including which patient subsets might actually benefit from surgical staging and the magnitude of that benefit. Definitive guidelines were not established for assessment of lymphatic dissemination. Different institutional or physician philosophies are reflected in the various staging and treatment algorithms. The diversity of opinions regarding surgical staging which includes lymph node sampling, ranges from those whose opinion is that staging is required for all patients even when the a priori risk of nodal involvement is extremely low through to those who consider that staging is unnecessary in any patient. This review examines some data regarding surgical staging in patients with clinically early endometrial cancer and the impact on survival and toxicity of this approach.
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