Para‐aortic lymphadenectomy did not improve overall survival among women with type I endometrial cancer

• Published in: International journal of gynecology and obstetrics Vol. 150; no. 2; pp. 163 - 168
• Main Authors: Li, Lin, Tang, Mingming, Nie, Dan, Gou, Jinhai, Li, Zhengyu
• Format: Journal Article
• Language: English
• Published: United States 01.08.2020
• Subjects: Para‐aortic lymphadenectomy; Pelvic lymphadenectomy; Prognosis; Retrospective analysis; Surgery outcomes; Type I endometrial cancer; Retrospective analysis; Surgery outcomes; Pelvic lymphadenectomy; Type I endometrial cancer; Prognosis; Para-aortic lymphadenectomy
• ISSN: 0020-7292; 1879-3479
• DOI: 10.1002/ijgo.13228

Objective To compare outcomes and prognosis among women with type I endometrial cancer undergoing hysterectomy and bilateral salpingo‐oophorectomy (H‐BSO) with or without systematic pelvic lymphadenectomy (PLD) or para‐aortic lymphadenectomy (PALD). Methods Retrospective review of women postoperatively diagnosed with type I endometrial cancer who underwent H‐BSO at a university hospital in Chengdu, China (January 2010 to June 2012). Women were divided into no lymphadenectomy (PLD−/PALD−), systematic pelvic lymphadenectomy (PLD+/PALD−), or combined pelvic and para‐aortic lymphadenectomy (PLD+/PALD+) groups. Follow‐up was by telephone. Postoperative outcomes and prognosis were compared and risk factors were analyzed. Results In total, 333 women met the inclusion criteria: 121 underwent PLD+/PALD−, 166 underwent PLD+/PALD+, and 46 underwent PLD−/PALD−. There were no differences in pre‐operative characteristics among the groups (all P>0.05). The PLD+/PALD+ group had a higher laparotomy rate (P=0.001), the PLD−/PALD− group had shorter operation time (P=0.001) and lower blood loss (P<0.001). There were no differences between the PLD+/PALD− and PLD+/PALD+ groups. Overall, 291 women had sufficient follow‐up data; there was no difference in overall survival, and PALD was not a predictor of survival. Conclusion Postoperative outcomes were similar among all surgical groups; a survival benefit of PALD was not demonstrated. Additional para‐aortic lymphadenectomy did not improve surgical outcomes or prognosis for women undergoing hysterectomy/bilateral salpingo‐oophorectomy and pelvic lymphadenectomy for type I endometrial cancer.