Is the extent of pelvic lymphadenectomy in the staging of endometrial cancer associated with the yield of metastatic nodes? An Israeli Gynecologic Oncology Group study. (September 2020)

• Record Type: Journal Article
• Authors: Rottenstreich, Misgav; Gemer, Ofer; Helpman, Limor; Hag-Yahia, Nasreen; Eitan, Ram; Raban, Oded; Lavie, Ofer; Ben Arie, Alon; Amit, Amnon; Levy, Tally; Namazov, Ahmed; Voldarsky, Michael; Ben Shachar, Inbar; Atlas, Ilan; Bruchim, Ilan; Vaknin, Zvi
• Is Part Of: Surgical oncology. Volume 34(2020)
• Page Start: 46
• Page End: 50
• Publication Date: 2020-09
• Subjects: Endometrial cancer -- Lymphadenectomy -- Pelvic -- Survival -- Staging; Cancer -- Surgery -- Periodicals; Neoplasms -- surgery -- Periodicals; Cancer -- Chirurgie -- Périodiques; Electronic journals; 616.994059
• DOI: 10.1016/j.suronc.2020.03.004
• Languages: English
• ISSNs: 0960-7404

Abstract

Abstract: Objectives: Primary, to explore correlation between the extent of pelvic lymphadenectomy in the surgical staging of endometrial cancer and the number of nodes with metastasis. Secondary, evaluate survival measures in relation to the number of excised nodes. Methods: A retrospective multi-center study of prospectively collected information of 2014 women with endometrial cancer, 1032 of whom underwent lymph node staging. Spearman's rank correlation was used to assess the correlation between the number of pelvic nodes excised and the number of metastatic nodes. Women's data were dichotomized by the median number of excised pelvic nodes. Kaplan-Meier and log rank tests were used to examine the effect of the number of pelvic nodes excised on survival. Results: There was no significant correlation between the number of pelvic nodes harvested and the number of metastatic lymph nodes (r = 0.301; p = 0.28). The median number of excised pelvic nodes was 9 (range 1–77). There was no difference between women with up to 9 and women with more than 9 lymph nodes excised in the 5-year recurrence-free survival (82.4% vs. 83.9%; p = 0.90), disease-specific survival (83.6% vs. 86.7%; p = 0.37), or overall survival (75.8% vs. 82.8%; p = 0.11). Conclusions: The extent of pelvic lymphadenectomy in the surgical staging of endometrial cancer is not associated with a higher yield of metastatic nodes or with longer survival. Current focus should be on sentinel node procedures that offer women the benefit of accurate staging without the complications associated with extensive lymphadenectomy. Highlights: The extent of pelvic lymphadenectomy in staging of endometrial cancer is not associated with the number of positive nodes. The extent of pelvic lymphadenectomy is not associated with the rate of at least one positive nodes. There was no difference in survival between excision up to 9 nodes or more.