Abstract
Objective. The objective of this study is to ascertain whether omission of lymphadenectomy could be possible when uterine corpus cancer is considered low-risk based on intraoperative pathologic indicators. Patient and Methods. Between 1998 and 2007, a total of 83 patients with low risk corpus cancer (endometrioid type, grade 1 or 2, myometrial invasion ≦50%, and no intraoperative evidence of macroscopic extrauterine spread, including pelvic and paraaortic lymph node swelling and adnexal metastasis) underwent the total abdominal hysterectomy and bilateral salpingo-oophorectomy without lymphadenectomy. A retrospective review of the medical records was performed, and the disease-free survival (DFS), overall survival (OS), peri- and postoperative morbidities and complications were evaluated. Results. The 5-year DFS rates and the 5-year OS rates were 97.6% and 98.8%, respectively. No patient presented postoperative leg lymphedema and deep venous thrombosis. Conclusion. Omission of lymphadenectomy did not worsen the DFS or OS. The present findings suggest that systemic lymphadenectomy could be omitted in low-risk endometrial carcinoma.
Highlights
Endometrial cancer is the most frequently occurring gynecologic malignancy
Most of the cancers are detected at an early stage by common symptom such as postmenopausal bleeding, with the tumor confined to the uterine corpus, so the prognosis is generally favorable and surgery alone may result in a cure
The International Federation of Gynecology and Obstetrics (FIGO) recommended in 1988 that adequate surgical staging requires a total abdominal hysterectomy, bilateral salpingo-oophorectomy (TAH-BSO) including pelvic and paraaortic lymphadenectomy [4], and according to this recommendation, some surgeons believe that lymphadenectomy should be performed in all cases to enable the accurate staging and to assess the necessity for postoperative treatment
Summary
Endometrial cancer is the most frequently occurring gynecologic malignancy. It accounts for 6% of all cancers in women, and causes approximately 42,000 deaths annually, which represents 3% of cancer deaths in women in the United States [1]. We retrospectively reviewed the cases of low-risk corpus cancer, which were treated in our hospital, and clarified that lymphadenectomy did not provide a significant survival advantage, and increased peri- and postoperative morbidities and complications [6]. According to these results, since 1998, lymphadenectomy have been omitted in low-risk corpus cancer in our hospital. Since 1998, lymphadenectomy have been omitted in low-risk corpus cancer in our hospital We retrospectively reviewed these cases and evaluated whether omission of lymphadenectomy for low-risk corpus cancer worsen the disease-free survival (DFS), overall survival (OS), and avoid peri- and postoperative morbidities and complications
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