Routine pelvic lymphadenectomy in apparently early stage endometrial cancer.

Abstract

AIMS:

Controversial issues with respect to the treatment of patients with endometrial cancer include indications for lymphadenectomy and adjuvant radiotherapy.

PATIENT AND METHODS:

Between 1998 and 2004 all women with endometrial cancer stage I were included (n = 335). They all underwent total abdominal hysterectomy and bilateral salpingo-oöphorectomy. Two hundred and thirty-seven women also had a pelvic lymphadenectomy. When pelvic lymphadenectomy was performed, radiotherapy was administered only to patients with lymph-node metastases. Otherwise, adjuvant radiotherapy was based on the presence of risk factors.

RESULTS:

Eleven patients had lymph-node metastases. The overall absolute and relative survival-estimate at 5 years was 85.0 and 93.7%, respectively. Loco-regional recurrence was 8.5%. In the group with pelvic lymphadenectomy and negative lymph nodes these rates were 88.2, 93.9 and 5.6%, respectively. In 58 patients without any of the risk factors tumour grade III, deep myometrial invasion, or age > or =60 years, no lymph-node metastases were found.

CONCLUSION:

In patients with endometrial cancer FIGO stage I without risk-factors, a phenomenon which occurs in about 25% of patients with clinical stage I endometrial cancer, a lymphadenectomy can be omitted. In other patients, the debate regarding the optimal treatment will remain.

• Authors: L D Zuurendonk, R A Smit, B W J Mol, H W H Feijen, J de Graaff, D Sykora, K A J de Winter, A vd Wurff, M P M L Snijders, R F P M Kruitwagen
• Journal: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology (Eur J Surg Oncol) Vol. 32 Issue 4 Pg. 450-4 (May 2006) ISSN: 0748-7983 [Print] England
• PMID: 16546343 (Publication Type: Comparative Study, Journal Article, Multicenter Study)

Topics

• Carcinoma (radiotherapy, secondary, surgery)
• Endometrial Neoplasms (pathology, radiotherapy, surgery)
• Female
• Humans
• Lymph Node Excision (methods)
• Lymphatic Metastasis
• Middle Aged
• Neoplasm Staging
• Pelvis
• Radiotherapy, Adjuvant
• Retrospective Studies
• Risk Factors
• Treatment Outcome