THE ROLE OF STAGING LAPAROTOMY IN GRADING GYNECOLOGICAL MALIGNANCIES
Soma Tahir Abdulla a, Tahir Abdulla Hussein a, and Maryam Bakir Mahmood b
a Sulaimani Maternity Teaching Hospital, Sulaimani, Kurdistan Region, Iraq.
b Sulaimani Maternity Teaching Hospital, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.
Submitted: 27/5/2022; Accepted: 21/10/2022; Published: 21/12/2022
DOI Link: https://doi.org/10.17656/jsmc.10377
Staging laparotomy can provide optimal care for gynecological malignancies by avoiding over treatment and under treatment.
The aim was to explore the difference between surgical and clinical disease staging of gynecological malignancies.
Patients and Methods
A retrospective observational study was performed on 30 women who were operated on for gynecological malignancies and were admitted to the Sulaimani Maternity Teaching Hospital from January 2019 to December 2020. Inclusion criteria included women diagnosed with gynecological malignancies before staging laparotomy. However, exclusion criteria included previous abdominal surgeries for other gynecological malignancies. In addition, demographic features, previous diagnostic methods, and intraoperative staging were recorded.
The mean±SD (standard deviation) age was 51.8±14.9 years (range, 12 to 72), and the majority (56.7%) was between 50-69 years. The mean±SD of patients’ gravida and para were 4.5±3.5 (range, 0-12) and 3.4±2.8 (range, 0-8), respectively. In addition, 20% of women had a personal history (13.3%) of tumors or familial history (6.7%)—most women (50%) presented with abnormal vaginal bleeding, either postmenopausal or menstrual abnormalities. Most women with endometrial tumors (50%) had been afflicted with adenocarcinoma (endometrioid type); however, the most common types of ovarian tumors were granulosa cell tumor, papillary serous adenocarcinoma, and malignant ovarian dysgerminoma in 10%, 10%, and 6.7%, respectively. The association between clinical staging and staging laparotomy was significant. There was a 60% upgrade from a lower stage to a higher stage; however, downgrading was only 3.3%.
The current study showed a significant association between clinical staging and staging laparotomy of gynecological malignancies.
Endometrial cancer; Gynecological cancer; Grading; Ovarian cancer; Sulaimani.
1. Jemal A, Siegel R, Ward E, Hao Y, Xu J, Murray T, et al. Cancer Statistics, 2008. CA Cancer J Clin. 2008;58(2):71–96.
2. Ries LAG, Young JL, Keel GE, Eisner MP, Lin YD, Horner MD. Cancer Survival Among Adults: US SEER Program, 1988-2001 Patient and Tumor Characteristics. 2007. 1988–2001 p.
3. Mining L, Patrono MG, Gallego RA, Bernabé JV De, Diaz-Padilla I. Surgical Treatment of Ovarian Cancer. In: Ovarian Cancer - A Clinical and Translational Update. Madrid: INTECH; 2013. p. 161–82.
4. Siegel R, Desantis C, Virgo K, Stein K, Mariotto A, Smith T, et al. Cancer Treatment and Survivorship Statistics, 2012. CA CANCER J CLIN. 2012;62(4):220–41.
5. Bookman MA, Brady MF, Mcguire WP, Harper PG, Alberts DS, Friedlander M. Evaluation of New Platinum-Based Treatment Regimens in Advanced-Stage Ovarian Cancer : A Phase III Trial of the Gynecologic Cancer InterGroup. J Clin Oncol. 2009;27(9):1419–25.
6. Benedet J, Denny L, Jones HW, Kavanagh J, Kitchener H, Kohorn E, et al. Staging Classifications and Clinical Practice Guidelines for Gynaecological Cancers. In: FIGO Committee on Gynecologic Oncology Guidelines. 2006. p. 1–160.
7. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin. 2013;63(1):11–30.
8. Sonoda Y. Surgical treatment for apparent early-stage endometrial cancer. Obs Gynecol Sci. 2014;57(1):1–10.
9. Pecorelli S. Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. Int J Gynaecol Obs. 2009;105(2):103–4.
10. Bristow RE, Santillan A, Diaz-Montes TP, Gardner GJ, Giuntoli RL, Meisner BC, et al. Centralization of care for patients with advanced-stage ovarian cancer: A cost-effectiveness analysis. Cancer. 2007;109(8):1513–22.
11. Engelen MJA, Kos HE, Willemse PHB, Aalders JG, De Vries EGE, Schaapveld M, et al. surgery by consultant gynecologic oncologists improves survival in patients with ovarian carcinoma. Cancer. 2006;106(3):589–98.
12. Grabowski JP, Harter P, Buhrmann C, Lorenz D, Hils R, Kommoss S, et al. Re-operation outcome in patients referred to a gynecologic oncology center with presumed ovarian cancer FIGO I-IIIA after the sub-standard initial surgery. Surg Oncol. 2012;21(1):31–5.
13. Harter P, Gnauert K, Hils R, Lehmann TG, Fisseler-Eckhoff A, Traut A, et al. Pattern and clinical predictors of lymph node metastases in epithelial ovarian cancer. Int J Gynecol Cancer. 2007;17(6):1238–44.
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