Introduction/Background Lymph node (LN) involvement is one of the most important independent prognostic factors in endometrial cancer (EC).
The present study set out to describe the clinical-pathological variables and surgical morbidity of patients undergoing surgical staging in a tertiary referral centre, as well as to compare overall survival (OS), disease-free survival (DFS) and recurrence in relation to LN involvement.
Methodology The Oncology-Gynaecology Committee evaluated all patients and therapeutic decision was based on the institutional therapeutic protocols for EC.Myometrial infiltration ≥50%, Grade III (FIGO) and EC type II were inclusion criteria; patients with surgical contraindication were excluded.
Surgical staging consisted on systematic bilateral pelvic and para-aortic lymphadenectomy. Survival was determined from last treatment (surgical or adjuvant) until July 2018.
Clinical data were retrospectively collected from computerized medical histories, registered on an informatics platform (Clinapsis) and exported to a database for statistic evaluation.
Results Sixty-three patients (2009-2016 period) were analysed. Clinical-pathological, surgical and histopathology results are summarized in tables 1 and 2.
LN involvement in pelvic (p=0.049) and para-aortic nodes (p=0.040) is related to poorer OS. Pelvic node involvement (p=0.006) is related to poorer DFS.
In case of negatives nodes and taking into account the number of nodes removed, it was observed an improvement in DFS in case of more than 10 nodes removed in the pelvic area (0.006).
Conclusion Lymphadenectomy allows tailoring adjuvant treatment in 21,3% of positive pelvic and/or para-aortic nodes. In our data, 4.9% of skip metastasis was evidenced. There is a potential benefit effect of pelvic lymphadenectomy in those cases of >10 nodes removed even in negative cases. A better selection of patients who would benefit from LN dissection is mandatory. Sentinel node assessment or molecular characterization should help to avoid morbidity related to surgical staging in those cases with less risk of nodal involvement.
Disclosure Nothing to disclose.
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