Lymph node dissection in intermediate and high-intermediate risk
endometrial cancer
Abstract
Introduction The aim of this study was to assess the impact of lymph
node dissection (LND) on survival for patients with intermediate risk
(IR) and high intermediate risk (HIR) endometrial cancer (EC). Methods
Clinicopathologic features and survival data of 1294 consecutive
patients who underwent primary surgical treatment for EC between 2003
and 2018 were were retrieved from the database of Hacettepe University
Hospital. This study compared the overall survival (OS) and disease-free
survival (DFS) among IR and HIR EC between patients with LND and no LND.
Results The study population included 141 (55 %) IR, and 115 (45 %)
HIR EC patients. LND was not performed in 33 (23.4%), and 31 (27%)
patients in IR, and HIR EC patients, respectively. The lymph node
involvement was 10.3% (n=20) among all patients. During the median
follow-up of 41 months (range, 12–222), 12 (6.2 %) patients with LND,
and 5 (7.8 %) patients without LND had disease recurrence (p=0.77). LND
did not improve OS and DFS in IR and HIR EC patients (p=0.92, p=0.80).
And the lymph node count was not associated with OS and DFS for all
subsets of patients with EC grouped by recurrence risks. Discussion
Without illuminating the morbidity of LND, there were no difference
observed in OS and DFS between IR and HIR EC patients with LND-induced
complications and no LND. With this regard, the use of sentinel lymph
node procedure might be better for minimizing the possible
post-operative morbidities in this selected patient groups.