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Archives of Gynecology and Obstetrics

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01-12-2010 | Gynecologic Oncology

The role of lymphadenectomy in uterine carcinosarcomas (malignant mixed mullerian tumours): a critical literature review

Authors: G. Vorgias, S. Fotiou

Published in: Archives of Gynecology and Obstetrics | Issue 6/2010

Abstract

Background

Uterine carcinosarcomas are rare and highly aggressive tumours. Although surgery is the cornerstone of treatment, the extent of the procedure remains controversial. We sought to evaluate the available literature data regarding the rationale of lymphadenectomy and its possible impact on survival.

Methods

A systematic Medline, PubMed and Scopus search with special focus on the publications of the last decade.

Results

Carcinosarcomas have similar clinical characteristics and behaviour with grade 3 endometrioid or aggressive variants of uterine adenocarcinoma. All studies have demonstrated that the FIGO stage of disease is the most important prognostic factor, followed by the depth of myometrial invasion, extra-uterine spread and positive peritoneal cytology. Moreover, lymph node involvement will be found in 14–38% of patients undergoing lymphadenectomy. This figure is similar to the one reported for endometrial carcinoma. Therefore, lymphadenectomy is mandatory for staging purposes. Regarding its impact on survival, the majority of studies confirm a significant survival benefit. The possible mechanisms for the improvement of survival from lymphadenectomy include removal of micro-metastatic foci, reduction of recurrence risk (removal of “target tissue”) and mechanical circumvallate of the disease. Given that 5–38% of the patients will experience local recurrence and 30–83% distant metastases, lymphadenectomy reduces the risk of the first and identifies patients in advanced stage that may benefit from adjuvant chemotherapy, aiming to reduce the second and ultimately improve overall survival.

Conclusions

Our review data fully justifies the rationale of lymphadenectomy, which beyond staging information seems to offer a measurable survival benefit.

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Title: The role of lymphadenectomy in uterine carcinosarcomas (malignant mixed mullerian tumours): a critical literature review
Authors: G. Vorgias
S. Fotiou
Publication date: 01-12-2010
Publisher: Springer-Verlag
Published in: Archives of Gynecology and Obstetrics / Issue 6/2010
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-010-1649-0

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

The role of lymphadenectomy in uterine carcinosarcomas (malignant mixed mullerian tumours): a critical literature review

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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