Diagnostic Usefulness of Intraoperative Ultrasonography in Avoiding Unnecessary Para-Aortic Lymphadenectomy in Women With Endometrial Carcinoma

作者：Ryo Eiji^*; Yasugi Toshiharu; Mizutani Katsumi; Kita Tsunekazu; Takeshita Shigeki; Ayabe Takuya

来源：International Journal of Gynecological Cancer, 2011, 21(5): 859-863.

DOI：10.1097/IGC.0b013e31821a35ef

• Endometrial carcinoma
• Intraoperative ultrasonography
• Lymphadenectomy
• Para-aortic lymph node
• Ultrasound

Objective: To evaluate the usefulness of intraoperative ultrasonography (IU) in reducing the number of unnecessary para-aortic lymphadenectomy in women with endometrial carcinoma.
Methods: Computed tomography (CT) and IU were used to assess whether para-aortic lymph nodes were enlarged in 91 women with endometrial carcinoma. All women underwent hysterectomy and systematic pelvic and para-aortic lymphadenectomy. On the basis of the intrauterine pathological findings (IPF) of the removed uterus, the women were classified into low-and high-risk groups. It was assumed that para-aortic lymphadenectomy would be performed only when enlarged nodes were detected by CT or IU or only when women were classified into the high-risk group. The numbers of women who would have had missed metastases and who could have avoided para-aortic lymphadenectomy were calculated.
Results: Eighteen women had pathological para-aortic node metastases. Theoretically, the number of women who would have had missed metastases on the basis of CT, IU, and IPF were 11, 2, and 2, respectively; more metastases were missed with CT than with the other 2 methods. The number of women who could have avoided para-aortic lymphadenectomy on the basis of CT, IU, and IPF were 84, 59, and 29, respectively; compared to IPF, IU helped avoid para-aortic lymphadenectomy in more women.
Conclusions: Intraoperative ultrasonography is the most efficient method for avoiding both unnecessary para-aortic lymphadenectomy and missed para-aortic node metastases in women with endometrial carcinoma.

• 出版日期2011-7