Introduction/Background*The objective of the study was to determine the potential impact of systematic lymphadenectomy vs. no lymphadenectomy on the perioperative change in QoL in patients undergoing surgical treatment for early stage endometrial cancer.

Methodology Patients scheduled for surgical treatment of clinically early stage endometrial cancer at the Department of gynecological oncology at the University Clinic of Gynecology and Obstetrics in Skopje, in the period January – December 2018 were approached for participation. Eligible subjects were divided into two groups: Group 1 (no LND) consisted of 60 patients who had hysterectomy plus bilateral salpingo-oophorectomy without lymph node dissection (LND); Group 2 consisted of 24 patients who had hysterectomy plus salpingo-oophorectomy plus systematic pelvic LND. Quality of life was quantified using a standardized and validated questionnaire (FACT-G) preoperatively and 30 days after surgical treatment.

Result(s)*A total of 91 patients were recruited in the study. Of those, 7 patients (7.7%) were excluded from statistical analysis: 6 (6.6%) patients with incomplete questionnaires and one patient (1%) who was unavailable for evaluation one month after surgery. The remaining 84 patients (92.3%) were selected for analysis, 60 patients in group 1 (no LND) and 24 patients in group 2 (LND).The patients in the LND group exhibited statistically significantly lower postoperative scores for FACT-G (87.7 vs 75.8 for the no LND and LND groups respectively, p=0.002), as well as for the physical wellbeing domain (23.4 vs. 20, p=0.004) and emotional wellbeing domain (20.7 vs 17, p=0.008). Twelve patients from the group with no lymphadenectomy (20%) experienced a clinically significant decline in the postoperative QoL, compared to 12 patients (50%) in the lymphadenectomy group (p=0.006).

Conclusion*There was a significant decrease in the postoperative QoL 30 days after surgery in patients that undergo systematic pelvic lymphadenectomy for early stage endometrial cancer compared to patients that do not. Women undergoing surgery for endometrial cancer should be counseled about the potential benefits of surgical staging including LND, which can influence their postoperative treatment in a significant manner, as well as the possible negative impact of the treatment on the short-term QoL.