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  • EP160/#126  Survival benefit of paraaortic lymph node evaluation in endometrioid endometrial carcinoma; a 10-year retrospective study in Thailand

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AS04. Endometrial/Uterine corpus cancers
EP160/#126  Survival benefit of paraaortic lymph node evaluation in endometrioid endometrial carcinoma; a 10-year retrospective study in Thailand
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  1. Atthapon Jaishuen1,
  2. Pattra Wisarnsirirak2,
  3. Janjira Petsuksiri3,
  4. Perapong Inthasorn1,
  5. Sompop Kuljarusnont1,
  6. Khemanat Khemworapong1 and
  7. Vitcha Poonyakanok1
  1. 1Faculty of Medicine Siriraj Hospital, Mahidol University, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Bangkok, Thailand
  2. 2Faculty of Medicine, Thammasat University, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Pathumthani, Thailand
  3. 3Faculty of Medicine Siriraj Hospital, Mahidol University, Division of Radiation Oncology, Department of Radiology, Bangkok, Thailand

Abstract

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.

Abstract EP160/#126 Figure 1
Abstract EP160/#126 Figure 1

Kaplan-Meier analysis of (A) 5-year OS of PLN and PPALN evaluation, (B) 5-year OS of PLN evaluation, PPALN evaluation with negative and positive PALN, (C) 5-year DSS of PLN and PPALN evaluation, (D) 5-year DSS of PLN evaluation, PPALN evaluation with negative and positive PALN, (E) 5-year RFS of PLN and PPALN evaluation, (F) 5-year RFS of PLN evaluation, PPALN evaluation with negative and positive PALN. *PPALN = pelvic and paraaoltic lymph node, PLN = pelvic lymph node, PALN = paraaortic lymph node

Abstract EP160/#126 Figure 2
Abstract EP160/#126 Figure 2

Kaplan-Meier analysis of 5-year DSS of PLN and PPALN evaluation stratified by ESGO/ESTRO/ESP risk groups (A) Low risk (B) Intermediate risk (C) High-intermediate risk (D) High risk

https://doi.org/10.1136/ijgc-2023-IGCS.252

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