Standardization of Hysterectomy Procedure to Indicate Laparoscopic Minimum Invasive Surgery for Patients with Endometrial Cancer

publisherシンポジウム2「子宮体癌治療戦略の新展開」, 第63回日本産科婦人科学会・学術講演会, Copyright (c) 2011, 公益社団法人日本産科婦人科学会, right: 本文は学協会の許可を得てCiNiiから複写したものである, WATANABE, Yoh[Synopsis] We evaluated the indication criteria for laparoscopic minimally invasive surgery in patients with endometrial cancer. We performed a detailed clinicopathological study on patients with parametrial spread (PRMS) who had undergone radical hysterectomy. Our results showed that positive PRMS was observed even in patients negative for cervical involvement, and that PRMS was frequently observed in patients with carcinoma of the lower uterine segment and those with deep myometrial invasion, but not in patients with carcinoma of the uterine fundus. Our present study findings revealed that minimally invasive laparoscopic simple hysterectomy can be indicated for patients with endometrial cancer showing the following preoperative clinicopathological findings: (1) preoperative magnetic resonance imaging showing no carcinoma of the lower uterine segment, (2) no obvious interruption of the junctional zone of the middle or lower uterine segment, and (3) no macroscopic cervical involvement similar to adenocarcinoma of the uterine cervix