ENDOMETRİUM KANSERİ CERRAHİSİNDE ASPİRATÖR SIVISI İÇERİĞİNDE LENF NODU ARAŞTIRILMASI

Öz

Amaç: Lenfadenektomi esnasında kullanılan aspirator içeriğinde lenf nodu olup olmadığının araştırılması amaçlanmıştır. Materyal ve Metod: Histerektomiye ek olarak pelvik ve paraaortik lenfadenektomi yapılan 83 endometrium kanseri çalışmaya dahil edildi. Hastaların operasyonu esnasında kullanılan aspirator içeriğinde lenf nodu olup olmadığı araştırıldı. Sonuçları değerlendirmek için tanımlayıcı istatistik kullanıldı ve elde edilen değerler ortalama ± SD ve yüzde olarak sunuldu. Bulgular: Hastaların %89.2’si endometrioid tip adenokanser iken, %10.8’i seröz veya berrak hücreli kanser idi. Ortalama çıkartılan lenf nodu sayısı 68.8±21.1’di, para-aortik bölgeden ortalama 34.1±16.6 ve pelvik bölgeden ortalama 35.3±11.7 lenf nodu çıkarıldı. Olguların %7.2’inde pelvik lenf nodu metastazı ve %8.4’inde paraaortik lenf nodu metastazı saptandı. Hastaların 5 tanesinde (%6) süzülen aspiratör içeriğinde lenf nodu saptandı, bu lenf nodlarının hiçbirisi metastatik değildi. Sonuç: Aspiratör içeriğinin süzülerek elde edilen materyalin patolojiye gönderilmesi daha fazla lenf nodu değerlendirilmesine olanak sağlayabilir

Anahtar Kelimeler

• Endometrium kanseri, lenfadenektomi, aspirator

ANALYSIS OF THE ASPIRATOR LIQUID CONTENT FOR LYMPH NODES IN ENDOMETRİAL CANCER SURGERY

Öz

Aim: To investigate whether there is lymph node or not in fluid content of aspirator which is used during lymphadenectomy. Material and Method: 83 endometrial cancer patient which treated with hysterectomy plus pelvic and para-aortic lymphadenectomy were included to study. The aspirator-irrigator fluid content has investigated whether there is lymph node or not. Descriptive statistics were used to evaluate and results presented as mean ±SD and percentage. Results: 89.2% of the patients were endometrioid type adenocarcinoma, whereas 10.8% were serous or clear cell carcinoma. Averaged 68.8±21.1 lymph nodes were removed totally, averaged34 ±16.6 para-aortic lymph nodes and 35.3±11.7 pelvic lymph nodes were removed. 7.2% pelvic and 8.4% para-aortic lymph node metastasis were detected. In 5 of all patients (6%), there were lymph node in filtered aspirator liquid content, none of these lymph nodes were metastatic. Conclusion: Sending the material obtained by filtration of the aspirator fluid content to pathology, can provide an opportunity for the assesment more lymph node.

Anahtar Kelimeler

• Endometrial cancer, lymphadenectomy, aspirator

Kaynakça

1. 1. Creasman WT, Morrow CP, Bundy BN, Homesley HD, Graham JE, Heller PB.Surgical pathologic spread patterns of endometrial cancer. A Gynecologic Oncology Group Study.Cancer. 1987 Oct 15;60(8 Suppl):2035-41.
2. 2. Giede C, Le T, Power P, Le T, Bentley J, Farrell S, Fortier MP, Giede C, Kupets R, Plante M, Power P, Renaud MC, Schepansky A, Senikas V, Kwon J,Préfontaine M, Germain I, Pearcey R, D’Souza D, Senterman M, Hoskins P The role of surgery in endometrial cancer. J Obstet Gynaecol Can. 2013 Apr;35(4):370-4.
3. 3. Sharma C, Deutsch I, Lewin SN, Burke WM, Qiao Y, Sun X, Chao CK, Herzog TJ, Wright JD. Lymphadenectomy infl uences the utilization of adjuvant radiation treatment for endometrial cancer. Am J Obstet Gynecol. 2011 Dec;205(6):562. 4. Zaino, Richard J. FIGO Staging of Endometrial Adenocarcinoma: A Critical Review and Proposal. International Journal of Gynecological Pathology: 2009;28 (1): 1-10.
4. 5. ACOG Practice Bulletin. Clinical management guidelines for obstetrician gynecologists, management of endometrial cancer. Obstet Gynecol 2005; 106:413–25
5. 6. Greer B, Koh W, Abu-Rustum NR, et al. Uterine neoplasms. Version 1. Fort Washington PA: National Comprehensive Cancer Network; 2008.
6. 7. Maneschi F, Ceccacci I, Perugini A, Pane C, Simeone A, Manicone A Endometrial cancer: prognostic signifi cance of risk classifi cation based on pre-intraoperative fi ndings. Arch Gynecol Obstet. 2011 Jul 22
7. 8. Abu-Rustum NR. J Natl Compr Canc Netw. 2014 Feb 1;12(2):288-97. Sentinel lymph node mapping for endometrial cancer: a modern approach to surgical staging. J Natl Compr Canc Netw. 2014 Feb 1;12(2):288-97.
8. 9. Abu-Rustum NR, Khoury-Collado F, Pandit-Taskar N, et al Gynecol Oncol 2009;113:163–169. Sentinel lymph node mapping for grade 1 endometrial cancer: is it the answer to the surgical staging dilemma?

9. 10. Moore DH, Fowler WC Jr, Walton LA, Droegemueller W. Obstet Gynecol. 1989 Aug;74(2):180-4. Morbidity of lymph node sampling in cancers of the uterine corpus and cervix.
10. 11. Hidaka T, Kato K, Yonezawa R, Shima T, Nakashima A, Nagira K, Nakamura T, Saito S. Omission of lymphadenectomy is possible for low-risk corpus cancer. Eur J Surg Oncol. 2007 Feb;33(1):86-90. Epub 2006 Nov 13.
11. 12. Larson DM, Johnson K, Olson KA. Obstet Gynecol. 1992 Jun;79(6):998-1001. Pelvic and para-aortic lymphadenectomy for surgical staging of endometrial cancer: morbidity and mortality