Endometrial cancer: predictors and oncological safety of tumor tissue manipulation

Purpose The main goal of this study is to assess the impact of tumor manipulation on the presence of lympho-vascular space invasion and its influence on oncological results. Methods We performed a retrospective multi-centric study amongst patients who had received primary surgical treatment for appa...

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Published inClinical & translational oncology Vol. 26; no. 5; pp. 1098 - 1105
Main Authors Quintana-Bertó, Raquel, Padilla-Iserte, Pablo, Lago, Víctor, Tauste, Carmen, Díaz-Feijoo, Berta, Cabrera, Silvia, Oliver-Pérez, Reyes, Coronado, Pluvio J., Martín-Salamanca, María Belén, Pantoja-Garrido, Manuel, Marcos-Sanmartin, Josefa, Cazorla, Eduardo, Lorenzo, Cristina, Rodríguez-Hernández, José Ramón, Roldán-Rivas, Fernando, Gilabert-Estellés, Juan, Muruzábal, Juan Carlos, Cañada, Antonio, Domingo, Santiago
Format Journal Article
LanguageEnglish
Published Cham Springer International Publishing 01.05.2024
Subjects
Medicine
Medicine & Public Health
Oncology
Research Article
Hysteroscopy
Oncological outcomes
Endometrial cancer
Uterine manipulator
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Abstract Purpose The main goal of this study is to assess the impact of tumor manipulation on the presence of lympho-vascular space invasion and its influence on oncological results. Methods We performed a retrospective multi-centric study amongst patients who had received primary surgical treatment for apparently early-stage endometrial cancer. A multivariate statistical analysis model was designed to assess the impact that tumor manipulation (with the use of uterine manipulator or preoperative hysteroscopy) has on lympho-vascular development (LVSI) in the final surgical specimen. Results A total of 2852 women from 15 centers were included and divided into two groups based on the lympho-vascular status in the final surgical specimen: 2265 (79.4%) had no LVSI and 587 (20.6%) presented LVSI. The use of uterine manipulator was associated with higher chances of lympho-vascular involvement regardless of the type used: Balloon manipulator (HR: 95% CI 4.64 (2.99–7.33); p  < 0.001) and No-Balloon manipulator ([HR]: 95% CI 2.54 (1.66–3.96); p  < 0.001). There is no evidence of an association between the use of preoperative hysteroscopy and higher chances of lympho-vascular involvement (HR: 95% CI 0.90 (0.68–1.19); p  = 0.479). Conclusion Whilst performing common gynecological procedures, iatrogenic distention and manipulation of the uterine cavity are produced. Our study suggests that the use of uterine manipulator increases the rate of LVSI and, therefore, leads to poorer oncological results. Conversely, preoperative hysteroscopy does not show higher rates of LVSI involvement in the final surgical specimen and can be safely used.
AbstractList Purpose The main goal of this study is to assess the impact of tumor manipulation on the presence of lympho-vascular space invasion and its influence on oncological results. Methods We performed a retrospective multi-centric study amongst patients who had received primary surgical treatment for apparently early-stage endometrial cancer. A multivariate statistical analysis model was designed to assess the impact that tumor manipulation (with the use of uterine manipulator or preoperative hysteroscopy) has on lympho-vascular development (LVSI) in the final surgical specimen. Results A total of 2852 women from 15 centers were included and divided into two groups based on the lympho-vascular status in the final surgical specimen: 2265 (79.4%) had no LVSI and 587 (20.6%) presented LVSI. The use of uterine manipulator was associated with higher chances of lympho-vascular involvement regardless of the type used: Balloon manipulator (HR: 95% CI 4.64 (2.99–7.33); p  < 0.001) and No-Balloon manipulator ([HR]: 95% CI 2.54 (1.66–3.96); p  < 0.001). There is no evidence of an association between the use of preoperative hysteroscopy and higher chances of lympho-vascular involvement (HR: 95% CI 0.90 (0.68–1.19); p  = 0.479). Conclusion Whilst performing common gynecological procedures, iatrogenic distention and manipulation of the uterine cavity are produced. Our study suggests that the use of uterine manipulator increases the rate of LVSI and, therefore, leads to poorer oncological results. Conversely, preoperative hysteroscopy does not show higher rates of LVSI involvement in the final surgical specimen and can be safely used.
The main goal of this study is to assess the impact of tumor manipulation on the presence of lympho-vascular space invasion and its influence on oncological results. We performed a retrospective multi-centric study amongst patients who had received primary surgical treatment for apparently early-stage endometrial cancer. A multivariate statistical analysis model was designed to assess the impact that tumor manipulation (with the use of uterine manipulator or preoperative hysteroscopy) has on lympho-vascular development (LVSI) in the final surgical specimen. A total of 2852 women from 15 centers were included and divided into two groups based on the lympho-vascular status in the final surgical specimen: 2265 (79.4%) had no LVSI and 587 (20.6%) presented LVSI. The use of uterine manipulator was associated with higher chances of lympho-vascular involvement regardless of the type used: Balloon manipulator (HR: 95% CI 4.64 (2.99-7.33); p < 0.001) and No-Balloon manipulator ([HR]: 95% CI 2.54 (1.66-3.96); p < 0.001). There is no evidence of an association between the use of preoperative hysteroscopy and higher chances of lympho-vascular involvement (HR: 95% CI 0.90 (0.68-1.19); p = 0.479). Whilst performing common gynecological procedures, iatrogenic distention and manipulation of the uterine cavity are produced. Our study suggests that the use of uterine manipulator increases the rate of LVSI and, therefore, leads to poorer oncological results. Conversely, preoperative hysteroscopy does not show higher rates of LVSI involvement in the final surgical specimen and can be safely used.
The main goal of this study is to assess the impact of tumor manipulation on the presence of lympho-vascular space invasion and its influence on oncological results.PURPOSEThe main goal of this study is to assess the impact of tumor manipulation on the presence of lympho-vascular space invasion and its influence on oncological results.We performed a retrospective multi-centric study amongst patients who had received primary surgical treatment for apparently early-stage endometrial cancer. A multivariate statistical analysis model was designed to assess the impact that tumor manipulation (with the use of uterine manipulator or preoperative hysteroscopy) has on lympho-vascular development (LVSI) in the final surgical specimen.METHODSWe performed a retrospective multi-centric study amongst patients who had received primary surgical treatment for apparently early-stage endometrial cancer. A multivariate statistical analysis model was designed to assess the impact that tumor manipulation (with the use of uterine manipulator or preoperative hysteroscopy) has on lympho-vascular development (LVSI) in the final surgical specimen.A total of 2852 women from 15 centers were included and divided into two groups based on the lympho-vascular status in the final surgical specimen: 2265 (79.4%) had no LVSI and 587 (20.6%) presented LVSI. The use of uterine manipulator was associated with higher chances of lympho-vascular involvement regardless of the type used: Balloon manipulator (HR: 95% CI 4.64 (2.99-7.33); p < 0.001) and No-Balloon manipulator ([HR]: 95% CI 2.54 (1.66-3.96); p < 0.001). There is no evidence of an association between the use of preoperative hysteroscopy and higher chances of lympho-vascular involvement (HR: 95% CI 0.90 (0.68-1.19); p = 0.479).RESULTSA total of 2852 women from 15 centers were included and divided into two groups based on the lympho-vascular status in the final surgical specimen: 2265 (79.4%) had no LVSI and 587 (20.6%) presented LVSI. The use of uterine manipulator was associated with higher chances of lympho-vascular involvement regardless of the type used: Balloon manipulator (HR: 95% CI 4.64 (2.99-7.33); p < 0.001) and No-Balloon manipulator ([HR]: 95% CI 2.54 (1.66-3.96); p < 0.001). There is no evidence of an association between the use of preoperative hysteroscopy and higher chances of lympho-vascular involvement (HR: 95% CI 0.90 (0.68-1.19); p = 0.479).Whilst performing common gynecological procedures, iatrogenic distention and manipulation of the uterine cavity are produced. Our study suggests that the use of uterine manipulator increases the rate of LVSI and, therefore, leads to poorer oncological results. Conversely, preoperative hysteroscopy does not show higher rates of LVSI involvement in the final surgical specimen and can be safely used.CONCLUSIONWhilst performing common gynecological procedures, iatrogenic distention and manipulation of the uterine cavity are produced. Our study suggests that the use of uterine manipulator increases the rate of LVSI and, therefore, leads to poorer oncological results. Conversely, preoperative hysteroscopy does not show higher rates of LVSI involvement in the final surgical specimen and can be safely used.
Author Marcos-Sanmartin, Josefa
Quintana-Bertó, Raquel
Pantoja-Garrido, Manuel
Martín-Salamanca, María Belén
Tauste, Carmen
Rodríguez-Hernández, José Ramón
Lago, Víctor
Domingo, Santiago
Roldán-Rivas, Fernando
Coronado, Pluvio J.
Muruzábal, Juan Carlos
Gilabert-Estellés, Juan
Oliver-Pérez, Reyes
Padilla-Iserte, Pablo
Cazorla, Eduardo
Cabrera, Silvia
Lorenzo, Cristina
Díaz-Feijoo, Berta
Cañada, Antonio
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  surname: Lorenzo
  fullname: Lorenzo, Cristina
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  givenname: José Ramón
  surname: Rodríguez-Hernández
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Issue 5
Keywords Hysteroscopy
Oncological outcomes
Endometrial cancer
Uterine manipulator
Language English
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SSID ssj0055611
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Snippet Purpose The main goal of this study is to assess the impact of tumor manipulation on the presence of lympho-vascular space invasion and its influence on...
The main goal of this study is to assess the impact of tumor manipulation on the presence of lympho-vascular space invasion and its influence on oncological...
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SubjectTerms Medicine
Medicine & Public Health
Oncology
Research Article
Title Endometrial cancer: predictors and oncological safety of tumor tissue manipulation
URI https://link.springer.com/article/10.1007/s12094-023-03310-6
https://www.ncbi.nlm.nih.gov/pubmed/37668932
https://www.proquest.com/docview/2861304666
Volume 26
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