Pomen limfadenektomije pri raku endometrija

Iztok Takač (Author), Darja Arko (Author), Robert Bali (Author), Nina Čas-Sikošek (Author), Borut Gorišek (Author), Dunja Zukanović (Author)

Abstract

Izhodišča. Limfogeno širjenje je glavni način razsoja raka endometrija. Bezgavke, v katere rak najpogosteje zaseva, se nahajajo ob medeničnih in retroperitonejskih žilah. Pelvična in aortna limfadenektomija se zato izvajata zaradi opredelitve razširjenosti raka, a tudi zaradi odstranitve rakastih celic. Metode. Limfadenektomija je indicirana pri bolnicah s srednjimin visokim tveganjem za prisotnost zasevkov v bezgavkah, kamor sodijo zmerno in slabo diferencirani tumorji, tumorji s prodorom v več kot polovico debeline miometrija, tumorji, ki se širijo v vrat maternice, ter svetlocelični, skvamozni in serozno papilarni tumorji. Pri bolnicah z nizkim tveganjem za prisotnost zasevkov v bezgavkah (dobro diferencirani tumorji, tumorji brez invazije ali z invazijo do polovice debeline miometrija) pomen limfadenektomije ni jasen. Zaradi načina limfogenega širjenja je potrebno odstraniti povrhnje obturatorne, zunanje iliakalne ter skupne iliakalne bezgavke. Notranje iliakalne, globoke obturatorne, globoke skupne iliakalne, presakralne in aortne bezgavke je potrebno odstraniti le pri bolnicah, pri katerih z zmrzlim rezom potrdimo zasevke v bezgavkah. Zaključki. Natančna limfadenektomija omogoča izbiro bolnic, pri katerih je potrebno dopolnilno zdravljenje. Njena poglavitna vloga je individualna prilagoditev ustreznega načina dopolnilnega zdravljenja.

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Data

Language:	Slovenian
Year of publishing:	2003
Typology:	1.08 - Published Scientific Conference Contribution
Organization:	UM - University of Maribor
UDC:	616-006
COBISS:	1309503
ISSN:	1318-0347
Views:	2699
Downloads:	69
Average score:	0 (0 votes)
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Other data

Secondary language:	English
Secondary title:	ǂThe ǂrole of lymphadenectomy in endometrial cancer
Secondary abstract:	Background. Lymphatics are the main pathway for distant spread of endometrial cancer. The node groups most commonly involved are located along the iliac and retroperitoneal vessels. Therefore, pelvic and aortic lymphadenectomy are performed for staging and therapeutic purposes. Methods. Lymphadenectomy is indicated in patients having moderate to high risk of lymph mode metastasis (grade 2 and 3 tumor myoinvasion > 50%, clear cell, squamous and serous papillary tumors). In patients with low risk for node metastasis (myometrial invasion absent or < 50% with grades 1 lymphadenectomy is questionable. Patterns of lymphatic spread indicate that lymphadenectomy should include superficial obturator, external iliac, and common iliac nodes. Internal iliac, deep obturator, deep common iliac, presacral and aortic nodes should be removed only from patients having node metastases at frozen section. Conclusions. A thorough staging lymphadenectomy provides more accurate information to select patients who are candidates for adjuvant treatment. The main role of this procedure is an individualized tailoring of adequate adjuvant treatment.
Secondary keywords:	Endometrial neoplasms;Endometrij, novotvorbe;Lymphadenectomy;Limfadenektomija;Neoplasm staging;Novotvorba, določitev stadija;
URN:	URN:NBN:SI
Type (COBISS):	Not categorized
Pages:	Str. II-43 - II-46
ID:	9111513