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A Journal on Obstetrics and Gynecology
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Scopus, Emerging Sources Citation Index
Minerva Ginecologica 2017 Apr 10
Copyright © 2017 EDIZIONI MINERVA MEDICA
Outcome of endometrial cancer after lymphadenectomy, a single center retrospective analysis of 829 cases with long-lasting follow-up
Pantaleo GRECO 1, Ruby MARTINELLO 1, Ugo INDRACCOLO 2, Chiara BORGHI 1, Gloria BONACCORSI 1, Gennaro SCUTIERO 1 ✉
1 Section of Obstetrics and Gynecology, Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Cona, Ferrara, Italy; 2 Complex Operative Unit of Obstetrics and Gynecology, Alto Tevere Hospital of Città di Castello, Città di Castello, Perugia, Italy
BACKGROUND: Role of lymphadenectomy in endometrial cancer is unclear. Our objective is to assess the role of lymphadenectomy in endometrial cancer.
METHODS: 829 cases of endometrial cancer from a single non-oncological center were reviewed retrospectively from 1981 to 2014. Multivariable Cox regression analyses were performed. Independent variables were: 2009 FIGO stage, histological type of endometrial cancer (non-endometrioid, endometrioid, grading 1, 2 and 3), radicality on parametria, lymphatic dissection (any kind) (yes/no), any kind of chemotherapy, any kind of radiotherapy, brachytherapy, patients' age. Dependent variable was death for endometrial cancer and first relapse. Time variable was the semester of follow-up. P value for significance was set <0.05.
RESULTS: Many data about the extension of node dissection were missing. Pelvic node dissection or sampling seem the more common procedure performed. At the 10-semester of follow-up, at the 20-semester of follow-up and at the 30 semester of follow up, lymphadenectomy does not improve overall survival at a p value of less than 0.05. Lymphadenectomy reduces the risk of relapse at the 10 semester and 20-semester of follow-up.
CONCLUSIONS: Lymphadenectomy plays a role in preventing relapses but it is not proved that non-aggressive lymphadenectomy in endometrial cancer improves overall survival at p level of 0.05. Therefore, it cannot be excluded that a very small improvement in long lasting survival in few cases of endometrial cancer could be due to node dissections.
KEY WORDS: Endometrial cancer - Follow-up - Lymphadenectomy - Survival