Article Text
Abstract
Introduction/Background Endometrial cancer is the fourth most common cancer in women in the developed countries. Although lymphadenectomy, particularly pelvic, is part of the surgical procedure for staging, its importance as a prognostic and therapeutic measure is in dispute.
The aim of this study is to explore the relationship between positive-pelvic lymph-node ratio (PPLNR) and disease-specific-survival (DSS), time to recurrence and overall-survival (OS) among women with endometrial cancer (EC).
Methodology A retrospective multi-center study of the Israeli Gynecologic Oncology Group (IGOG). In this study, we prospectively collected the information of consecutive women with EC who underwent surgery in one of 11 medical-centers between 2002–2014. During the study-period, 2014 women were treated and reviewed, 1,032 underwent lymph-node staging of whom 117 had PPLN. We used Kaplan-Meier and log-rank tests to determine the threshold LNR associated with survival.
Results 117 women were included in the study, for 104 women we had data regarding all the evaluated outcome-measures. A higher number of excised metastatic lymph-nodes was associated with decreased survival. Kaplan-Meier analysis determined a threshold of LNR=0.4. Women with PPLNR>0.4 had decreased DSS (P<0.01) time to recurrence (p<0.02) and OS (P<0.017) relative to those with PPLNR<0.4. No other clinically significant differences were found between the groups.
The 10-year Overall Survival rate
Conclusion Our data suggest that PPLNR can be used as another prognostic tool in women with advanced EC. Future studies will help to define a precise threshold of PPLNR to implement this prognostic factor in daily practice.
Disclosures There is no conflict interest.