To evaluate the therapeutic benefit of
lymphadenectomy and adjuvant
therapy, in particular
chemotherapy, we retrospectively analysed survival rates and patterns of recurrence of
endometrioid adenocarcinoma in 106 patients who underwent surgery including retroperitoneal
lymphadenectomy.
Adjuvant chemotherapy was administered to 46 patients (42 received a
platinum-based regimen) and pelvic irradiation to 12. The 5-year survival rate of 23 patients with
lymph node metastasis was worse than that of patients without
lymph node metastasis (60% vs 96%, P<0.0001). Recurrence was observed in 14 patients (10 patients with
chemotherapy, two with irradiation, and two without adjuvant
therapy); the first site of recurrence was in distant sites in 12 patients; recurrence in the pelvic sidewall or exclusively in lymph nodes was not observed. The 5-year survival rate of 18 patients with
lymph node metastasis treated with
chemotherapy, was 61% including all 14 with macroscopically positive nodes and all nine with paraaortic
metastasis. Of seven patients with bulky positives nodes, three patients with bulky paraaortic nodes died of the disease, three of the four patients with bulky pelvic but without bulky paraaortic nodes had no recurrence. In summary,
lymphadenectomy may afford a survival benefit via the debulking of macroscopically positive nodes, and the predominance of distant recurrences suggests that
chemotherapy is a suitable choice as an adjuvant
therapy in
endometrial carcinoma after
lymphadenectomy.