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#554 Is there a prognostic value for the positive lymph-node ratio? An israeli gynecologic oncology group study
  1. Zvi Vaknin1,2,
  2. Perry eliassi Revivo3,
  3. Ahmet Namazov4,5,
  4. Limor Helpman6,
  5. Ram Eitan7,
  6. Ofer Lavie8,9,
  7. Amnon Amit10,
  8. Tally Levy11,
  9. Inbar Ben Shachar12,13,
  10. Ilan Atlas14,
  11. Ilan Bruchim15,
  12. Alon Ben Arie16,17 and
  13. Ofer Gemer4
  1. 1Department of Obstetrics and Gynecology, The Yizhak Shamir (formerly Assaf Harofeh) Medical Center, Zerifin, Rishon-Le-Tzyon, Israel
  2. 2Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
  3. 3Department of Obstetrics and Gynecology, The Yizhak Shamir (formerly Assaf Harofeh) Medical Center, Zerifin., Rishon-Le-Tzyon, Israel
  4. 4Department of Obstetrics and Gynecology, Barzilai Medical Center, Ashkelon, Israel
  5. 5Faculty of Health Sciences, Ben-Gurion University of Negev, Beer-Sheva, Israel
  6. 6Department of Obstetrics and Gynecology, Meir Medical Center, Kfar-Saba, Israel
  7. 7Department of Obstetrics and Gynecology, Rabin Medical Center, Petah Tikva, Israel
  8. 8Department of Obstetrics and Gynecology, Carmel Medical Center, Haifa, Israel
  9. 9Rappaport Faculty of Medicine, Technion, Haifa, Israel
  10. 10Department of Obstetrics and Gynecology, Rambam Medical Center, Haifa, Israel
  11. 11Department of Obstetrics and Gynecology, Wolfson Medical Center, Holon, Israel
  12. 12Department of Obstetrics and Gynecology, Ziv Medical Center, Zefat, Israel
  13. 13Faculty of Medicine, Bar-Ilan University, Ramat-Gan, Israel
  14. 14Department of Obstetrics and Gynecology, Poriya Medical Center, Tiberia, Israel
  15. 15Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hedera, Israel
  16. 16Department of Obstetrics and Gynecology, Kaplan Medical Center, Rehovot, Israel
  17. 17Affiliated to The Faculty of Medicine, Hebrew University, Jerusalem, Israel


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.

Abstract #554 Figure 1

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.

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