Introduction To evaluate 5-year survival in patients with endometrioid endometrial carcinoma, who underwent evaluation of retroperitoneal pelvic lymph nodes alone, compared to evaluation of pelvic with paraaortic lymph nodes.
Methods This retrospective cohort study enrolled 636 women who were diagnosed with endometrioid endometrial carcinoma and underwent surgical staging at Faculty of Medicine Siriraj Hospital, Thailand between January 2006 and December 2015. Patients who underwent pelvic lymph node evaluation (n = 257) and pelvic with paraaortic lymph node evaluation (n = 379) were included.
Results The median follow-up time was 60 months. The 5-year overall survival rate (OS) in the pelvic lymph node (PLN) and pelvic with paraaortic lymph node (PPALN) groups was 81.6% and 87.7%, respectively (p = 0.073). However, the PPALN group had significantly longer survival than the PLN group after adjustment for other prognostic factors (adjusted HR 1.63 (1.06–2.52, p=0.028)). The five-year disease-specific survival rate (DSS) was 88.8% in the PLN group and 93.5% in the PPALN group (p =0.025). There was a trend to improve 5-year DSS for the ESGO/ESTRO/ESP high risk patients, who underwent PPALN evaluation (85.6%) compared with PLN evaluation (70.8%), p=0.061.
Conclusion/Implications In endometrioid endometrial carcinoma, patients who underwent evaluation of the pelvic and paraaortic lymph nodes had a significantly 5-year lower risk of death compared to only pelvic lymph node evaluation. Currently, we suggest performing pelvic and paraaortic lymph node evaluations in each patient with endometrioid endometrial carcinoma, especially in the ESGO/ESTRO/ESP high-risk patients.
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