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Re: Lymph node biopsy guidelines any gyn oncologist around? From: art fougner, md (evsono@pipeline.com) Sun Jan 20 07:41:20 2002 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Gail Waldby MD: "Re: Lymph node biopsy guidelines any gyn oncologist around?" Previous message: art fougner, md: "Re: Hot potato" In reply to: Gail Waldby MD: "Re: Lymph node biopsy guidelines any gyn oncologist around?" Next in thread: Gail Waldby MD: "Re: Lymph node biopsy guidelines any gyn oncologist around?" Reply: Gail Waldby MD: "Re: Lymph node biopsy guidelines any gyn oncologist around?" i would caution against over-reliance in noninvasive imaging studies - these are NOT equivalent to findings at surgery. if there is no gyn onc around to sample nodes, perhaps your friendly neighborhood general surgeon would be a second choice? also, consider pre op radiotherapy if the patient's situation suggests a high risk for nodal involvement. finally, agree with Gail - if you cannot offer the patient the standard of care, then refer to someone who can. just my opinion - i could be wrong. art At Sat, 19 Jan 2002, Gail Waldby MD wrote: > >If the standard of care is lymph node sampling and you cannot provide that >in your circumstances either because of lack of technical skills (or other >surgeons with those skills but unwilling to provide them), then you really >should not be doing the surgery. You should instead refer the patient to a >center where they will receive the standard of care. > >If you usually are careful to do only low grade good risk endometrial >cancers so you don't have to do node sampling and only infrequently find >yourself in a situation where you need a node sampling and can't provide >it, I would at that point refer the patient after surgery for node sampling >and reassess my skills and my facility's capabilities. >Gail Waldby, MD >Huron Clinic SD > >There is some support in the Radiology literature for X-ray staging of >endometrial cancer to avoid this second scenario--I think they are >recommending MRI but am not sure since I am currently reading about >ultrasound, CT and MRI all at once in different texts. > >At 02:45 PM 1/19/2002 -0600, you wrote: >>At Wed, 16 Jan 2002, C.Moi,M.D wrote: >> > >> >In my hospital in California,when one of us gynecologists anticipates or >> >finds an ovarian or endometrial carcinoma we call on the general >> >surgeons to come and do lymph node sampling, however there is almost >> >always a reluctance on their part to do so( they claim it does not >> >improve prognosis,very low chance of finding a positive node,etc.) >> >What guidelines do you folks folow in such cases? >> >I would love to hear the opinion of a gyn oncologist about that , wish >> >we had one on staff. >> >>I am surprised by the lack of response to this important question ! >>ok here's another scenario What do you do if you removed an endometrial >>cancer & found that it infiltrated deep and there is NO general surgeon >>available to come and do the nodes ? -- art fougner, md ich bin ein New Yorker Next message: Gail Waldby MD: "Re: Lymph node biopsy guidelines any gyn oncologist around?" Previous message: art fougner, md: "Re: Hot potato" In reply to: Gail Waldby MD: "Re: Lymph node biopsy guidelines any gyn oncologist around?" Next in thread: Gail Waldby MD: "Re: Lymph node biopsy guidelines any gyn oncologist around?" Reply: Gail Waldby MD: "Re: Lymph node biopsy guidelines any gyn oncologist around?"

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