Predictive Score of Nodal Involvement in Endometrial Cancer Patients: A Large, Multicenter Series

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EP1201 Laparoscopy versus laparotomy for surgical treatment of obese women with endometrial cancer: a cost-benefit comparative analysis

Introduction/Background Obesity represents a major health problem. Several studies reported that morbid obesity is associated with an 81% greater health care expenditure per capita compared with normal weight adults in the US. Although many articles have investigated costs of laparoscopic versus open approach for endometrial cancer, very few data are available in selected population of patients, such as obese women. The aim of this study has been to evaluate pre-, intra- and post-operative costs in obese women affected by endometrial cancer comparing laparoscopic versus open abdominal surgery. Methodology Economic expenditure in pre-operative, intra-operative and post-operative phases of th…

EPV145/#82 Multicentric predictive score validation for nodal assessment in endometrial cancer patients: preliminary data

Predictive Score of Nodal Involvement in Endometrial Cancer Patients: A Large Multicentre Series

Background: Sentinel lymph node (SLN) biopsy is considered the standard of care in early-stage endometrial cancer (EC). For SLN failure, a side-specific lymphadenectomy is recommended. Nevertheless, most hemipelvises show no nodal involvement. The authors previously published a predictive score of lymphovascular involvement in EC. In case of a negative score (value 3–4), the risk of nodal metastases was extremely low. This multicenter study aimed to analyze a predictive score of nodal involvement in EC patients. Methods: The study enrolled patients with EC who had received comprehensive surgical staging with nodal assessment. A preoperative predictive score of nodal involvement was calculat…

EP1155 Endoscopic near infrared and indocyanine green to verify the viability of the subcutaneous flap for vulvar cancer

Introduction/Background Vulvar cancer often requires radical vulvectomy with subsequent vulvar flap due to tumor aggressiveness and a high percentage of relapses. Approximately in 20–60% of cases, there are post-operative complications ranging from infection to wound dehiscence, lymphocele and flap necrosis that often require reoperation. Several methods have been described to verify the vitality of the flap, especially in plastic surgery, but these are often expensive and require specific machinery that is not generally present in a gynecological clinic. We present a viability verification of V-Y fasciocutaneous advancement flap for vulvar reconstruction by Endoscopic Near-Infrared and Ind…

Confounding factors of transvaginal ultrasound accuracy in endometrial cancer.

Endometrial cancer is the most frequently diagnosed gynecological tumour. Transvaginal ultrasound has a leading role in the preoperative evaluation of endometrial cancer patients. The study aimed to identify factors that can worsen the diagnostic accuracy of transvaginal ultrasound in endometrial cancer patients. We retrospectively analysed 290 patients with histological diagnosis of endometrial adenocarcinoma. Two-dimensional (2D) gray-scale ultrasound and power Doppler imaging were performed. Age, menopause status, obesity, parity, Figo stage and benign uterine disorders were evaluated as possible factors worsening the diagnostic accuracy of the ultrasonography. FIGO stage IB was the main…

Laparoscopy versus laparotomy for surgical treatment of obese women with endometrial cancer: A cost-benefit comparative analysis

The aim of the present study was to demonstrate the cost of obese patients affected by endometrial cancer undergoing open surgery compared with minimally invasive surgery. In the retrospective cohort study (Canadian Task Force classification II-2), the economic expenditure in pre-operative, intra-operative and post-operative phases of the selected patients was evaluated. Costs were analyzed for all blood tests, instrumental examinations, consultations, operating materials, drugs, gynecological examinations, hospital stay, intensive care hospitalization and management of operative complications. The average length of stay was longer for patients who underwent laparotomy, with an almost doubl…

Endoscopic near infrared and indocyanine green to verify the viability of the subcutaneous flap for vulvar cancer.

Abstract Introduction Vulvar cancer often requires radical vulvectomy with subsequent vulvar flap. Approximately in 20–60% of cases, there are post-operative complications ranging from infection to flap necrosis that often require reoperation. Several methods have been described to verify the vitality of the flap, but these are often expensive and require specific machinery that is not generally present in a gynecological clinic. In this case report, we present a viability verification of V Y fasciocutaneous advancement flap for vulvar reconstruction by Endoscopic Near-Infrared and Indocyanine Green. Methodology The patient was a 67-year-old woman with FIGO IB ≤ 4 cm squamous cell vulvar ca…

EP485 Confounding factors of trans-vaginal ultrasonography accuracy in endometrial cancer

Introduction/Background Endometrial cancer is the most frequently diagnosed gynecological tumor with more than 60.000 new cases each year. Following the ESMO-ESGO-ESTRO consensus conference, patients are classified in different classes of risk for lymph node metastases based on the instrumental suspected stage of the disease. In this scenario, a correct pre-operative workup is essential for a proper planning treatment offered to the patient. Although most of the oncological centers have replaced the MRI with trans-vaginal ultrasound, this, in the international guidelines, is considered only in the fertility sparing and in cases of contraindicated MRI. The Aim of our study is to evaluate the…

Novel preoperative predictive score to evaluate lymphovascular space involvement in endometrial cancer: an aid to the sentinel lymph node algorithm.

IntroductionSentinel lymph node (SLN) dissection has been recognized as a valid tool for staging in patients with endometrial cancer. Several factors are predictors of recurrence and survival in endometrial cancer, including positive lymphovascular space invasion. The aim of this study is to formulate a pre-operative score that, in the event of no-SLN identification, may give an estimate of the true probability of lymphovascular space invasion and guide management.MethodologyThis was a multi-institutional retrospective study conducted from January 2007 to December 2017. We included all patients with any grade endometrial tumor with a complete pathological description of the surgical specime…