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Simple Hysterectomy Fine if Parametrium Is Clear.
ST. JOHN'S, NFLD. -- Cone biopsy or simple hysterectomy without parametrium removal appears adequate in patients with clinical stage I cervical cancer and clear parametrial margins as long as the tumor size is no greater than 2 cm.
That was the finding of a prospective study reported by Dr. Joan Murphy at the annual meeting of the Society of Obstetricians and Gynaecologists of Canada.
Historically, parametrectomy, also known as radical hysterectomy, has been a key cause of postoperative complications associated with the surgery, and the issue of just how much parametrium to remove during surgery is a matter of debate.
Some study findings underscore the importance of removing the parametrium entirely regardless of tumor size, noting that parametrial metastases occur equally in the lateral and medial parametrium. Other studies suggest that only partial removal is necessary for small tumors.
In the midst of this debate, it's been routine practice to remove all or at least part of the parametrium for all but microinvasive squamous cell carcinomas.
In a study aimed at identifying risk factors predictive of pathologic parametrial involvement, Dr. Murphy and her associates at the University of Toronto prospectively analyzed data from 876 patients who underwent radical surgery for clinical stage I cervical cancer between July 1984 and January 2000. Of those, 39 patients had parametrial involvement defined as either positive parametrial lymph nodes or malignant cells in the parametrial tissue with either contiguous or discontiguous spread.
Age greater than 40 years and tumor sizes greater than 2 cm were highly predictive of parametrial involvement. There was a significant difference in recurrence-free survival between those with and without parametrial involvement.
- Collagen levels are lower in the parametrium of women with uterine...
- Magazine article from: Women's Health Weekly March 13, 2003 700+ words
...Collagen levels are lower in the parametrium of women with uterine prolapse. "Our...to compare the amount of collagen in parametrium and vaginal apex between women with...we obtained biopsies from the lateral parametrium and vaginal apex. The tissue was stained...
- parametrium
- Reference information from: The Mosby Medical Encyclopedia October 1, 1996 700+ words
The Mosby Medical Encyclopedia 10-01-1996 parametrium /per'um'trum/, pl. parametria, the tissue of the uterus that extends into the ligament, which helps support it. Compare...
- Findings from University of Texas in cervical cancer reported.
- Newspaper article from: Cancer Weekly August 11, 2009 700+ words
...To estimate the incidence of parametrial involvement and to evaluate factors associated...outcome of positive or negative parametrial involvement. Three hundred fifty patients...Overall, 27 women (7.7%) had parametrial involvement. The majority of specimens with...
- Pelvic lymph nodes appear to be good predictors of parametrial status.
- Newspaper article from: Cancer Weekly November 16, 2004 700+ words
...and 16 patients (14.9%) had parametrial involvement, mostly by direct extension...pelvic nodes (36.4%) had parametrial involvement, whereas among 85 patients with...eight patients (9.4%) had parametrial involvement (p<0.001), most in...
- Special Feature: American Women Are Not Receiving State-of-the-Art Care for...
- Magazine article from: OB/GYN Clinical Alert November 1, 2002 700+ words
...postoperative irradiation or chemoradiation for factors such as positive lymph nodes, positive surgical margins, parametrial involvement, or deep stromal penetration..sup.12 Patients who receive sequential modalities of radical surgery and...
- New data from C. Coutant et al illuminate research in cervical cancer risk...
- Newspaper article from: Cancer Weekly October 20, 2009 700+ words
...Radical hysterectomy and pelvic lymphadenectomy is recommended for stage Ia2-Ib1 cervical cancer while parametrial involvement (PI) is rare. Our aim was to evaluate criteria to select women with low risk of PI that could benefit from...
- Reports from University of Navarra advance knowledge in cervical cancer.
- Newspaper article from: Angiogenesis Weekly February 20, 2009 700+ words
...stromal invasion > 10 mm, lymph-vascular space involvement, tumor diameter > 17.5 mm, and parametrial involvement. Postoperative treatment was significantly more frequent in patients with ''abundant'' vascularization...
- Research from G.M. Gitau and colleagues provide new insights into sarcoma.
- Newspaper article from: Blood Weekly August 28, 2008 700+ words
...Pelvic examination revealed a 3-4 cm size cervical lesion distorting the cervical canal but with no obvious parametrial involvement." "Histology and immunohistochemistry on a wedge biopsy had features consistent with alveolar soft part...
