Role of the Appropriateness of the Pelvic Lymphadenectomy and Adjuvant Radiation Therapy in Early-Stage Poorly Differentiated Endometrial Carcinoma

Abstract

With this work, we intend to investigate the prognostic role of the pelvic lymphadenectomy, analyzing the pattern of recurrence in poorly differentiated endometrial carcinoma. Our study analyzes a total of 98 patients affected by early-stage (T1/T2) poorly differentiated endometrial carcinoma. Detailed data concerning clinical presentation, pathology, adjuvant treatment, and outcomes were collected and correlated with disease-free survival (DFS), further distinguished in local and distant DFS, and overall survival (OS). The extent of the lymphadenectomy was considered appropriated when a number of 12 lymph nodes were removed. The only characteristic significantly associated with locoregional DFS was the use of adjuvant radiation therapy (p: 0.003), whereas the use of adjuvant radiation therapy (RT, p: 0.004), the appropriateness of lymphadenectomy (p: 0.019), and the higher age (> 65 years, p: 0.037) are associated with distance DFS. The only significant variable associated with OS was the higher age (p: 0.025). On multivariate analysis, RT was correlated (p: 0.017) with locoregional DFS, whereas RT (p: 0.019) and age (p: 0.048) were correlated with distance DFS. The multivariate analysis of OS showed that the only parameter associated was the age (p: 0.047). The results of our study underline the importance of an appropriate lymphadenectomy and the selection of the correct adjuvant strategy in the treatment of early-stage poorly differentiated endometrial carcinoma.