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).
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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