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        Suboptimal Cytoreduction In Endometrial Cancer Associated With Decreased Survival: Presented at SGO

        By Charlene Laino
        Special to DG News

        NEW ORLEANS, LA -- February 10, 2003 -- Patients with advanced endometrial cancer who receive suboptimal cytoreductive surgery are more likely to experience complications or die than those who have optimal cytoreduction, a new study finds.

        Nicholas Lambrou, MD, an assistant professor of obstetrics and gynecology at the University of Miami in Miami, Florida, United States, presented the findings here on February 4th at the 34th Annual Meeting of the Society of Gynecologic Oncologists.

        The study enrolled all 84 patients with Stage III and Stage IV endometrial carcinoma who underwent surgical therapy at the University of Miami between 1990 and 2000. Sixty of the patients had Stage III disease and the rest, Stage IV disease.

        A review of the medical records revealed that optimal cytoreduction was achieved in 83% of patients. Seventeen percent of the women had suboptimal cytoreduction, defined as residual tumor of greater than 1 cm.
        Survival analysis and comparisons were performed using the Kaplan Meier method, the log rank test and Chi square analysis.

        Optimal cytoreduction was associated with a significant survival advantage for the entire cohort (p<0.039) and for patients with Stage III disease (p<0.034).

        While there were some concerns that optimal cytoreduction might increase intra- or postoperative complications, this was not the case, Dr. Lambrou reported.

        Suboptimal cytoreductive surgery, on the other hand, significantly increased the risk of being admitted to the intensive care unit or dying within 30 days of the procedure (p<0.0120 and p<0.0037, respectively).

        Suboptimal resectability was more likely to occur if the tumor had spread to the parametrium, adnexae or upper abdomen, he said, or if ascites were present at time of surgery.



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