Pelvic lymph node dissection and radiotherapy for high risk endometrial cancer : Optimize and individualize therapy for grade 3 endometrioid endometrial cancer patients.

Veltkamp, T.A.S. (2016) Pelvic lymph node dissection and radiotherapy for high risk endometrial cancer : Optimize and individualize therapy for grade 3 endometrioid endometrial cancer patients. thesis, Medicine.

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Abstract

Background. Treatment of high-risk endometrial cancer patients is intensive, radical and not specific. To optimize we have to individualize therapy. Objective. The aim of this study is to reduce the number of patients receiving a hysterectomy, bilateral salphingo-oophariectomy (BSO) and externa beam radiation therapy based on primary tumor data. Materials and methods. In this multi-center trial data of patients diagnosed with endometrioid endometrial cancer grade 3 between January 2011 and December 2015 were collected retrospectively. The patients underwent a MRI. With indiction of ≥50% myometrial invasion a hysterectomy, BSO and complete pelvic lymphadenectomy (LND) followed. In case of negative lymph nodes external beam radiation therapy (EBRT) was excluded, vaginal brachytherapy was considered. Results. Adaptation of the protocol resulted in a decrease of EBRT incidence from 38% to 17%. The PPV of endometrial sampling was 65% for grade 3 tumors and 55% for grade 3 endometrioid tumors. The PPV of MRI was 76% for ≥50% myometrial invasion. Of the patients with definitive grade 3 endometrioid endometrial cancer, 27.3% had lymph node metastases. None of the patients who did not receive EBRT after a LND developed lymph node metastases. Conclusion. The renewed protocol resulted in a significant decrease of EBRT incidence. The predictive value of endometrial sampling is lower than expected based on literature.

Item Type:	Thesis (Thesis)
Supervisor name:	Facultair begeleider: and Nijman, Prof. Dr. H. W. Gynaecoloog-oncoloog UMCG
Supervisor name:	Dagelijks begeleider: and Velden, Dr. J. van der Gynaecoloog-oncoloog AMC
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 11:07
Last Modified:	25 Jun 2020 11:07
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/2714

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