@article {{\O}rtoft68, author = {Gitte {\O}rtoft and Claus H{\o}gdall and Caroline Juhl and Lone K Petersen and Estrid S Hansen and Margit Dueholm}, title = {The effect of introducing pelvic lymphadenectomy on survival and recurrence rates in Danish endometrial cancer patients at high risk: a Danish Gynecological Cancer Group study}, volume = {29}, number = {1}, pages = {68--76}, year = {2019}, doi = {10.1136/ijgc-2018-000023}, publisher = {BMJ Specialist Journals}, abstract = {Objectives To evaluate the rate of survival and recurrence related to the introduction of pelvic lymphadenectomy in Danish high-risk endometrial cancer patients.Study design Data on 713 high-risk patients defined as grade 3 with \>50\% myometrial invasion or serous/clear/undifferentiated carcinomas stage I{\textendash}IV endometrial cancer patients diagnosed from 2005 to 2012 were retrieved from the Danish Gynecological Cancer Database. Of these, 305 were high-risk stage I. Five year Kaplan-Meier survival estimates and actuarial recurrence rates were calculated, and adjusted Cox used for comparison. Findings were compared with earlier Danish results.Results Lymphadenectomy in 390 radically operated high-risk patients resulted in upstaging of 31 patients from stage I to IIIC and 19 patients from stage II to IIIC corresponding to 12.8\%. Upstaging from stage I to IIIC had a cancer-specific survival of 77\%, almost comparable to lymph node-negative high-risk stage I patients (81\%). Lymphadenectomy patients had a significant higher overall survival as compared with non-lymph node resected for all patients, but not for stage I patients. Lymphadenectomy, however, did not significantly affect cancer-specific survival, progression-free survival, recurrence rate or risk of local, distant, or lymph node recurrence. When the survival of high-risk stage I patients was compared with earlier Danish results, a small improvement in overall survival (7\%) and cancer-specificsurvival (8\%) was demonstrated.Conclusion Only a small number of high-risk patients were upstaged from stage I to III due to lymphadenectomy. These patients showed a surprisingly good survival possibly due to correct stage identification and subsequent relevant adjuvant therapy. However, even though introduction of lymphadenectomy in the Danish high-risk population seems to increase overall survival, no significant change in cancer-specific survival, progression-free survival or recurrence patterns was demonstrated.}, issn = {1048-891X}, URL = {https://ijgc.bmj.com/content/29/1/68}, eprint = {https://ijgc.bmj.com/content/29/1/68.full.pdf}, journal = {International Journal of Gynecologic Cancer} }