In addition, some of these studies have included patients who had no comprehensive surgical staging, including lymphadenectomy
. Therefore, the main aim of the current investigation is to evaluate the prognostic factors, treatment options, and survival outcomes in patients with only surgically confirmed stage I UCS to minimize the factors that can affect survival.
However, whether loco-regional lymphadenectomy
should always be performed at the time of the primary tumor excision is a matter of debate, some claiming it does not improve the outcome [6, 13].
Adenocarcinomas of jejunum and ileum are best managed by wide segmental resection and regional lymphadenectomy
. For tumours involving distal ileum, a right hemicolectomy should be performed.
The rationale behind these additional procedures was to provide a better lymphadenectomy
. The Dutch MRC and Italian studies have shown that these procedures significantly increase morbidity and mortality (67-72), suggesting that a splenectomy and a pancreatectomy should not be routinely performed.
The assessment of sentinel node evaluation was initially conceptualised in the early 19705 and this obviated the need for routine lymphadenectomy
. This also identified a subset of patients at risk for locoregional spread.
The rates of patients who underwent lymphadenectomy
(68% and 76%) and removed lymph node numbers [median (min-max) 16 (2-35) and 14 (2-30)] were similar in both groups.
Five fertile patients underwent total abdominal hysterectomy together with bilateral salpingo-oophorectomy, pelvic and paraaortic lymphadenectomy
, and omentectomy.
diaphragm domes and pelvic peritonectomy, pelvic lymphadenectomy
Systematic pelvic lymphadenectomy
was performed in all patients, and para-aortic lymphadenectomy
was performed in 11 (27%) patients.
Recent data suggest sentinel lymph nodes are an effective alternative to complete lymphadenectomy
with high detection rates and sensitivity and negative predictive values (NPVs) (9,10) and no difference in recurrence-free survival.
Optimal extent of the operation in endometrial cancer covers panhysterectomy, peritoneal cytology, and pelvic lymphadenectomy
. In the case of abdominal metastases, paraaortic lymphadenectomy
, omentectomy, and metastasectomy are indicated.
The analysis included estimates of rates of lymphadenectomy
, bilateral mapping, and unilateral mapping, 3-year disease-specific survival, and overall survival, all of which were compared with third-party reimbursement costs at 2016 Medicare rates.