Efficacy of para-aortic lymphadenectomy in early-stage endometrioid uterine corpus cancer.

Abstract

PURPOSE:

The objective of this study was to assess whether para-aortic lymphadenectomy has therapeutic efficacy for patients with early-stage endometrioid uterine cancer who underwent systematic pelvic lymphadenectomy.

METHODS:

The authors retrospectively reviewed the medical records and pathological findings of 547 patients with histologically proven FIGO stage I-II endometrioid uterine cancer, based on comprehensive surgical staging, including pelvic with or without para-aortic lymphadenectomy.

RESULTS:

Among 547 patients, 330 patients had systematic pelvic lymphadenectomy only, and 217 had systematic pelvic with para-aortic lymphadenectomy. There were no significant differences in histopathological factors in the high-risk group, even though deep myometrial invasion (p = 0.02) and lymphvascular space invasion (p = 0.01) were more common in patients who underwent systematic pelvic with para-aortic lymphadenectomy in all study populations. Within a median follow-up of 31 (range, 5-120) months, there was no significant difference in overall survival between the pelvic lymphadenectomy only and pelvic with para-aortic lymphadenectomy groups in all populations (p = 0.77), even in high-risk patients (p = 0.82). Upon multivariate analysis, patients with lymphvascular space invasion had significantly worse overall survival (odds ratio (OR) = 7.38; 95% confidence interval (CI) = 1.86-29.23; p = 0.004).

CONCLUSIONS:

Although a prospective, randomized study needs to be performed for confirmation, our data suggest that the therapeutic benefit of para-aortic lymphadenectomy is uncertain in stage I and II endometrioid uterine corpus cancer, even in patients at high-risk for recurrence.

• Authors: Seo-Yun Tong, Jong-Min Lee, Jae-Kwan Lee, Jae Weon Kim, Chi-Heum Cho, Seok-Mo Kim, Sang-Yoon Park, Chan-Yong Park, Ki-Tae Kim
• Journal: Annals of surgical oncology (Ann Surg Oncol) Vol. 18 Issue 5 Pg. 1425-30 (May 2011) ISSN: 1534-4681 [Electronic] United States
• PMID: 21136177 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Aorta (pathology, surgery)
• Endometrial Neoplasms (pathology, surgery)
• Female
• Follow-Up Studies
• Humans
• Hysterectomy
• Lymph Node Excision
• Lymphatic Metastasis
• Middle Aged
• Myometrium (pathology, surgery)
• Neoplasm Recurrence, Local (pathology, surgery)
• Neoplasm Staging
• Pelvis (pathology, surgery)
• Retrospective Studies
• Survival Rate
• Treatment Outcome
• Uterine Neoplasms (pathology, surgery)