The role of routine pelvic lymph node sampling in patients with stage I endometrial carcinoma, second thoughts

• Published in: Acta obstetricia et gynecologica Scandinavica Vol. 77; no. 3; pp. 347 - 350
• Main Authors: Bar-Am, Amiram, Ron, Ilan-Gil, Kuperminc, Michael, Gal, Ilan, Jaffa, Ariel, Kovner, Felix, Wigler, Neli, Inbar, Moshe, Lessing, Joseph
• Format: Journal Article
• Language: English
• Published: Copenhagen, DK Munksgaard International Publishers 01.03.1998; Taylor & Francis
• Subjects: Biological and medical sciences; Carcinoma - mortality; Carcinoma - pathology; Carcinoma - surgery; Cohort Studies; Endometrial Neoplasms - mortality; Endometrial Neoplasms - pathology; Endometrial Neoplasms - surgery; Fallopian Tubes - surgery; Female; Female genital diseases; Follow-Up Studies; Gynecology. Andrology. Obstetrics; Humans; Hysterectomy; Incidence; Lymph Node Excision; Lymph Nodes - pathology; Lymphatic Metastasis - physiopathology; Medical sciences; Neoplasm Recurrence, Local - epidemiology; Neoplasm Staging; Ovariectomy; Pelvis; Prognosis; Retrospective Studies; Treatment Outcome; Tropical medicine; Tumors; Adenocarcinoma; Histological grading; Human; Prognosis; Malignant tumor; Female genital diseases; Pathology; Lymphadenectomy; Clinical stage; Surgery; Uterine diseases; Female; Endometrium; Comparative study
• ISSN: 0001-6349; 1600-0412
• DOI: 10.1034/j.1600-0412.1998.770318.x

The cases of 245 patients diagnosed during 1980-1989 with stage I endometrial carcinoma were retrospectively reviewed in order to assess the contribution of lymph node sampling (LNS) to both course of treatment and outcome. The 183 women treated by gyneco-oncologic surgeons had undergone the standard surgical procedure of total abdominal hysterectomy (TAH), bilateral salpingo-oophorectomy (BSO) and pelvic lymph node sampling (LNS). Sixty-two other women, treated by gynecologists, received only TAH and BSO. Of women who had received TAH+BSO+LNS, 105 (57.4%) were referred for adjuvant radiotherapy on the basis of one or any combination of high grade histology (G2 or G3), myometrial invasion to a depth of 50% or more and LNS positivity. Of the group who had not had LNS, 37 (59.7%) likewise received adjuvant radiotherapy but on the bases of histology and/or depth of invasion. Recurrence and survival over a mean follow-up period of 7.5 years (range 5-15 years) showed no significant differences between the patients who underwent LNS and those who did not. Of 43 recurrences, six were among 'low risk' women (those with both minimal invasion and low grade histology), suggesting a special need among this group for the additional staging information which LNS may provide.