Surgery for Carcinoma Endometrium
Fig. 16.1 Pelvic lymph node dissection. 1. Sigmoid-descending colon. 2. Common iliac nodes. 3. External iliac artery. 4. External iliac vein. 5. Obturator nodes. 6. Internal iliac artery The bowel…
Surgical Anatomy of the Uterus
Fig. 13.1 Uterosacral ligaments (AHRCC) Fig. 13.2 Uterosacral ligaments removed from attachment Transverse Cervical (Cardinal/Mackenrodt’s) Ligaments This serves as the main uterine support. They attach the lateral margins of the…
Basics of Robotic Instrumentation and Robotic-Assisted Surgery for Endometrial Cancer
Fig. 21.1 Surgeon console Fig. 21.2 Patient cart Robotic Technology It enables the surgeon to be more precise, improve their technique, and enhance their capability in performing complex minimally invasive…
Endometrial Cancer Staging
Fig. 14.1 Carcinoma endometrium, Stage 1A (T1a, N0, M0) Tumor Confined to the uterus, no or < ½ myometrial invasion, Stage 1B (T1b, N0, M0) Tumor Confined to the uterus,…
Surgical Management of Uterine Sarcoma
Fig. 31.1 Uterine leiomyosarcoma. Multi-lobulated grey-white tumor with areas of hemorrhage and microcysts Simple hysterectomy with or without bilateral salpingo-oophorectomy is the mainstay of surgical management of uterine LMS. Ovaries…
Adjuvant Radiation in Early-Stage Endometrial Cancer: Evidence, Principles, and Techniques
Risk stratification Factors Treatment Low risk Stage IA, grade I–II Observation Intermediate risk Stage IA, grade III; stage IB, grade I–II Vaginal brachytherapy (VBT) High risk Stage IB, grade III;…
The Role of Lymphadenectomy in Endometrial Cancer: The Mayo Clinic Experience
Route of recurrence Risk factors Hematogenous All stages of disease Myometrial invasion >50 % Stage I disease, negative LNs Myometrial invasion ≥66 % Lymphatic Pelvic/paraaortic LNs CSI, LN metastases Peritoneal…
Therapeutic Options for Early-Stage Uterine Papillary Serous Carcinomas, Carcinosarcomas, and Clear-Cell and Mixed-Cell Histologies
Fig. 23.1 Uterine papillary serous carcinoma. Note the fibrovascular core lined by stratified, pleomorphic cells, forming secondary papillae and cellular buds Clear-cell cancers are more varied, often characterized by tubulocystic,…
Palliative Care and End of Life Options for Patients with Endometrial Cancer
Disease related Neuropathy secondary to uncontrolled diabetes mellitus Tumor infiltration and nerve impingement Gynecologic malignancy-specific pain syndromes Lumbosacral plexopathy Pelvic pain Malignant psoas syndrome Treatment related Radiation-induced pain (e.g., proctitis,…
Smooth Muscle Tumors of Uncertain Malignant Potential of Uterine Origin
Fig. 38.1 CT scan showing enlarged uterus with cystic spaces and thinned out myometrium A differential diagnosis of uterine sarcoma/endometrial malignancy was made on imaging. CA125 and LDH were within…
