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.
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.
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