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#171 Long-term outcomes of different strategies to know the lymph node status in patients with intermediate, intermediate-high and high-risk endometrial cancer in early stages
  1. Jesús Molero Vílchez1,2,
  2. Ester Martínez Lamela2,3,
  3. Judith Suarez Aguado4,
  4. Angela Santiago Gómez5,
  5. Sonsoles Sancho García6 and
  6. Yolanda Expósito Lucena1
  1. 1Toco-Gyn Gynecologic Clinic, Alcalá De Henares, Spain
  2. 2Ntra Sra del Rosario University Hospital, Madrid, Spain
  3. 3Infanta Leonor University Hospital, Madrid, Spain
  4. 4Jiménez Ayala Institute, Madrid, Spain
  5. 5Advance Tecniques Cancer Center (ITACC), Madrid, Spain
  6. 6Ramón y Cajal University Hospital, Madrid, Spain


Introduction/Background To investigate the impact of performing a sentinel lymph node biopsy, a systematic lymphadenectomy, or no lymphadenectomy, in patients with intermediate, intermediate-high- and high-risk endometrial cancer in postoperative diagnosis in early stages.

Methodology Observational, longitudinal, analytical, and retrospective study. A total of 136 patients operated between January 2006 and March 2023, were reviewed. 22 patients with preoperative study of low risk: 6 patients underwent only sentinel lymph node biopsy (SLNB), 5 patients SLNB and pelvic lymphadenectomy (P-LND), and 11 without lymphadenectomy (No-LND). 114 patients with myometrial infiltration >50%, type II or G3 in the preoperative study: 44 patients underwent P-LND and 70 pelvic and paraaortic lymphadenectomy (P-Pa-LND). All patients received the adjuvant treatment decided in the Tumor Committee. Progression-free survival (PFS) and overall survival (OS) were estimated in the four groups.

Results The mean follow-up was 73 months. The mean of removed pelvic lymph nodes was 22 nodes (SD 9.3) and 22.8 (SD 10.3) para-aortic lymph nodes. Pelvic lymph nodes metastasis was observed in 27 cases (24.3%) and 17 cases (24.3%) in para-aortic nodes. In 6 cases para-aortic nodes were positive with negative pelvic lymph nodes (6/50 cases, 12.2%). Considering the P-Pa-LND as standard, no statistically significant differences were found in PFS respected to No-LND (HR: 0.5, 95% CI 0.1–1.7, p=0.27), SLNB (HR: 0.04, 95% CI 0–49.9, p=0.37) and P-LND (HR: 0.65, 95% CI 0.3–1.3, p=0.23); and in OS, respected to No-LND (1.42, 95% CI 0.3–5.3, p=0.6), SLNB (HR: 0.04, p=0.5) and P-LND (HR 1.39, 95% CI 0.5–3.2, p=0.44).

Abstract #171 Figure 1

Survival according to different strategies

Conclusion It has not been observed that performing different extended lymphadenectomy in intermediate to high-risk endometrial cancer in early stages worsens patient survival.

Disclosures There were no statistically significant differences between cases with lymph node metastasis and those without metastasis (Log Rank p=0.4; HR: 1.48, 95% CI 0.5–3.8, p=0.41).

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