Introduction/Background Surgical assessment of lymph nodes for endometrial cancer staging at primary surgery is one of the most varied practices worldwide and controversies remain about the need for and the extent of para-aortic lymph node dissection in all patient. This study aimed to determine whether a pelvic and para-aortic lymphadenectomy improves survivals compared with a pelvic lymphadenectomy alone in patients with endometrial cancer.
Methodology Data from all women with operated on for endometrial cancer between January 1998 and December 2013 were extracted from the Surveillance, Epidemiology and End Results database. Women treated with pelvic lymphadenectomy were matched with women treated with pelvic and para-aortic lymphadenectomy according to age and risk of recurrence. The primary and secondary endpoints were overall and disease-specific survivals respectively.
Results One to one matching enabled to compare the outcome of 1015 patients who underwent pelvic lymphadenectomy with 1015 patients who underwent pelvic and para-aortic lymphadenectomy. The 3-years overall survival probabilities for patients at intermediate and high risk of recurrence were similar in the pelvic and para-aortic lymphadenectomy group and the pelvic only group (91.2 and 86.4% respectively, p=0.07). Multivariate analysis of prognostic factors showed that in patients with an intermediate or high risk of recurrence, pelvic and para-aortic lymphadenectomy did not reduce the risk of death compared with pelvic lymphadenectomy (HR 1.08, 95% CI 0.69–1.69; p=0.74).
Conclusion The present study suggests that for patients with endometrial cancer at intermediate or high risk of recurrence, the extent of lymphadenectomy does not impact overall and disease-free survivals.
Disclosure Nothing to disclose.
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