vaginal hysterectomy for endometrial cancer

Vaginal Hysterectomy for Vaginal Hysterectomy for Endometrial Cancer Endometrial Cancer

Peng-Hui Wang Peng-Hui Wang

Department of Obstetrics and GynecologyDepartment of Obstetrics and Gynecology

Taipei Veterans General HospitalTaipei Veterans General Hospital

National Yang-Ming University School of MedicineNational Yang-Ming University School of Medicine

王鵬惠王鵬惠

台北榮民總醫院婦產部暨國立陽明大學醫學院婦產科學系台北榮民總醫院婦產部暨國立陽明大學醫學院婦產科學系

3 September 20083 September 2008

王鵬惠王鵬惠

王鵬惠王鵬惠

這個回顧性研究顯示經由陰道全子宮切這個回顧性研究顯示經由陰道全子宮切除，可以適用在一些子宮內膜癌的病人除，可以適用在一些子宮內膜癌的病人

AJOG 2007;197:202e1-202e7.AJOG 2007;197:202e1-202e7.

王鵬惠王鵬惠

• Several authors have described vaginal hysterectomy as a

reasonable alternative to other surgical methods for the

treatment of endometrial cancer, especially in the

morbidly obese, elderly, medically compromised, or

otherwise poor surgical candidate.

• For these selected patients, disease-free and overall

survival have been similar in women treated with

abdominal surgery.

前言前言

Gynecol Oncol 2005;96:362-7.Gynecol Oncol 2005;96:362-7.Obstet Gynecol 2001;97(5 Pt 1):707-11.Obstet Gynecol 2001;97(5 Pt 1):707-11.

王鵬惠王鵬惠

• Medical records were retrospectively reviewed for patients

undergoing vaginal hysterectomy for endometrial cancer a

t the University of South Florida.

• The medical data were reviewed for medical comorbidities,

preoperative and postoperative diagnosis, hospital course,

surgical and postoperative complications, adjuvant treatm

ents, and follow-up.

方法方法

AJOG 2007;197:202e1-202e7.AJOG 2007;197:202e1-202e7.

王鵬惠王鵬惠

結果結果

AJOG 2007;197:202e1-202e7.AJOG 2007;197:202e1-202e7.

王鵬惠王鵬惠 AJOG 2007;197:202e1-202e7.AJOG 2007;197:202e1-202e7.

結果結果


結果結果


結果結果

75.5%: low risk or intermediate “low” risk75.5%: low risk or intermediate “low” risk


結果結果

9.5% with postoperative adjuvant therapy9.5% with postoperative adjuvant therapy

王鵬惠王鵬惠

• Although vaginal hysterectomy is Although vaginal hysterectomy is not not considered the current standaconsidered the current standa

rd surgical treatment for endometrial cancer, we agree with others ird surgical treatment for endometrial cancer, we agree with others i

n the n the selective useselective use of this route for the surgical management of endo of this route for the surgical management of endo

metrial carcinoma. metrial carcinoma.

• The decision to proceed with vaginal hysterectomy should be made aThe decision to proceed with vaginal hysterectomy should be made a

fter fter careful evaluation of each individual patient with regard to age, careful evaluation of each individual patient with regard to age,

weight, medical comorbidities, anatomy, patient preference, presumweight, medical comorbidities, anatomy, patient preference, presum

ed grade and stage of tumor, quality of life, and in some cases adjuved grade and stage of tumor, quality of life, and in some cases adjuv

ant studies such as radiologic imaging.ant studies such as radiologic imaging.

AJOG 2007;197:202e1-202e7.AJOG 2007;197:202e1-202e7.

討論討論

王鵬惠王鵬惠

• An informed discussion with the patient and consultationAn informed discussion with the patient and consultation

with a gynecologic oncologist regarding this nontraditionwith a gynecologic oncologist regarding this nontradition

al approach are important. al approach are important.

• Vaginal hysterectomy may have an increased role in the tVaginal hysterectomy may have an increased role in the t

reatment of endometrial cancer as the reatment of endometrial cancer as the population continpopulation contin

ues to age and has increasing rates of obesity and coexistiues to age and has increasing rates of obesity and coexisti

ng medical comorbiditiesng medical comorbidities..

AJOG 2007;197:202e1-202e7.AJOG 2007;197:202e1-202e7.

討論討論

THE END

Thanks for your attendance and your attention

vaginal hysterectomy for endometrial cancer

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