603 Survival outcome and recurrence pattern after lymphadenectomy for endometrial cancer

Abstract

<h3>Introduction/Background*</h3> Standard surgical treatment for carcinoma endometrium comprise hysterectomy with pelvic and para aortic node dissection followed by adjuvant treatment depending on final pathology report. Systematic lymphadenectomy in endometrial cancer still remains as a controversial topic. <h3>Methodology</h3> To assess pattern of lymph node metastasis, pelvic control rate and overall and disease free survival outcome of cancer endometrium patients who underwent lymphadenectomy along with hysterectomy. Retrospective audit of patients who underwent lymphadenectomy as a part of staging from January 2010-December 2016. It includes 156 patients. Survival curves plotted using Kaplan-Meier method. Statistical significance assessed using log-rank test. <h3>Result(s)*</h3> Median follow up was 60 months. Overall survival (OS) and disease free survival (DFS) was significantly better in patients who underwent systematic pelvic and paraaortic node dissection rather than pelvic node dissection alone for stage III and IV Carcinoma endometrium (p=0.025). Multivariate analysis showed that lymph node dissection, age, lymph node metastasis, and adjuvant therapy were independent prognostic variables. <h3>Conclusion*</h3> Systematic pelvic and paraaortic lymph node dissection significantly prolongs the survival of patients with stage III and IV as well as grade 3 and type II carcinoma endometrium. Most common site of tumour recurrence in patients who didn’t undergo para aortic lymphadenectomy was para aortic area.