Evaluation of pelvic lymph node dissection in endometrial carcinoma

Abstract

Background : Pelvic and para-aortic lymphadenectomy is suggested to provide prognostic and therapeutic benefits in endometrial carcinoma, particularly in high-risk and advanced tumors. Aim : Herein we compare the oncological and surgical outcomes in patients with and without pelvic lymphadenectomy performed. Patients and Methods: A retrospective study, included endometrial carcinoma patients who underwent hysterectomy at National Cancer Institute, Egypt from January 2013 to December 2017. We divided the patients into two groups according to the documented operative details, one group was subjected to pelvic lymphadenectomy (PLN), and one group had no lymphadenectomy done (No PLN). Results : 90 patients (60 patients had PLN, 30 patients had no PLN). The death rate was higher in the No PLN group compared to the PLN (36.7% vs 20%). The mean overall survival (OS), and disease-free survival (DFS) were nearly equal in both groups. Retroperitoneal nodal recurrence occurred in 6 patients in the PLN group out of 18 recurrences (33.3%) and in 5 patients in the no PLN group out of 11 recurrences (45.5%) with a p-value=0.869. The 5-year DFS in PLN and No PLN groups was 50% and 26.7% respectively, and the 5-year OS in PLN and No PLN groups was 70%, and 60 %, respectively but statistically not significant. Early postoperative complications occurred in 24 patients (40%) in the PLN group and 12 patients (40%) in the No PLN group. Conclusion: Excluding patients with low risk for nodal disease in endometrial carcinoma, pelvic lymphadenectomy may have a positive impact on survival or recurrence patterns.