Efficacy of Para-Aortic Lymphadenectomy in Early-Stage Endometrioid Uterine Corpus Cancer
- Alternative Author(s)
- Cho, Chi Heum
- Publication Year
- 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.
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