Introduction/Background To compare surgery outcomes and prognosis for patients with type I endometrial cancer undergoing hysterectomy and bilateral salpingo-oophorectomy (H-BSO) with or without systematic pelvic lymphadenectomy (PLD) or para-aortic lymphadenectomy (PALD).
Methodology Patients with Type I endometrial cancer in West China Second University Hospital between January 2010 and June 2012 were comprehensively reviewed. Patients with synchronous cancer, synchronous surgery, or neoadjuvant therapy were excluded. Patients were objectively triaged to no-lymphadenectomy, PLD or PALD based on frozen section diagnosis. All patients received telephone follow-up. Surgery outcomes and prognosis were compared among H-BSO, PLD and PALD groups.
Results Total 333 patients met the inclusion criteria and 291 (87%) patients got effective follow-up data. In all patients, 121 (36%) had PLD, 166 (49%) had PALD and remaining 46 (14%) only had H-BSO. Based on preoperative assessment, there was no significant difference in age, menopause, body mass index among three groups (P>0.05), while H-BSO had higher Charlson Index (P=0.005). According to surgery and pathology data, PALD had higher laparotomy rate (P=0.00) than other two groups, H-BSO had lower operation time (P=0.001) and blood loss (P<0.001) while no difference existed between PLD and PALD. There was no significant difference in ascites, blood transfusion rate, FIGO pathology grade, tumor diameter among three groups (P>0.05). Follow-up information showed that three groups had no difference in overall survival, univariate and multivariate Cox regression model survival analyses showed that para-aortic lymphadenectomy was not a risk factor to type I endometrial cancer patients.
Conclusion Utilization of para-aortic lymphadenectomy for endometrial cancer results in similar surgical and oncologic outcomes and high laparotomy rate to H-BSO combined pelvic lymphadenectomy. The benefit of PALD should be further considered.
Disclosure Nothing to disclose.
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