2022-RA-1660-ESGO Lymphadenectomy in high-risk endometrial cancer

Abstract

<h3>Introduction/Background</h3> The role of lymphadenectomy in surgical management of endometrial cancer remains controversial. Lymph node metastases can be found in women who before surgery are thought to have cancer confined to the uterus. Removal of all pelvic and para-aortic lymph nodes at initial surgery has been widely advocated, and pelvic and para-aortic lymphadenectomy remains part of the FIGO staging system for endometrial cancer.The objective of this study was to determine the characteristics, complication rate and metastases location in high-risk endometrial cancer. <h3>Methodology</h3> Retrospective study of patients with high-risk endometrial cancer was performed. All patients underwent surgery including complete lymph node staging by pelvic and para-aortic lymphadenectomy. Clinicopathological characteristics, complication rate and location of lymph node metastases were analyzed. <h3>Results</h3> 147 women were diagnosed with high-risk endometrial cancer, representing 11.3% of all endometrial tumors in that period (n=1301).The mean age of the patients was 61.62 years, 88.4% were in the menopausal state and 40.8% of them had a BMI &gt; 30. Regarding histopathology, the most common type of tumor was endometrioid adenocarcinoma (37.4%), followed by serous carcinoma (31.3%). Regarding histological grade, 10.9% were G1, 11.6% were G2, and 77.6% were G3. Regarding lymph node spread, 34 (23.1%) patients had metastases in pelvic and/or para-aortic lymph nodes. 26 patients (17.7%) had positive pelvic nodes and 19 patients (12.9%) had positive para-aortic nodes. Once the final staging was carried out with the FIGO criteria (2009), the most frequent stage was IA (38.8%) and stage IIIC was 23.1%. 21 patients (14.3%) presented some type of complication related to surgery, the most frequent complications being lymphedema (2.7%) and lymphocele (2.7%). <h3>Conclusion</h3> In our study, the rate of lymph node metastases (pelvic and/or para-aortic) is 23.1% with a low rate of complications. We can affirm that it is a useful and safe technique.