No Survival Benefit of Node Removal in Endometrial Cancer
But lymphadenectomy improves surgical staging
WEDNESDAY, Nov. 26 (HealthDay News) -- Pelvic systematic lymphadenectomy does not improve disease-free or overall survival rates in patients with early-stage endometrial cancer, although it can provide better surgical staging, according to a study published online Nov. 25 in the Journal of the National Cancer Institute.
Pierluigi Benedetti Panici, M.D., from La Sapienza University in Rome, Italy, and colleagues randomly assigned 514 patients with stage I endometrial carcinoma to undergo pelvic systematic lymphadenectomy or no lymphadenectomy in addition to receiving a standard hysterectomy with bilateral salpingo-oophorectomy.
The researchers found that significantly more patients who underwent pelvic lymphadenectomy had early and late postoperative complications (81 patients with lymphadenectomy versus 34 no-lymphadenectomy patients). After a median of 49 months, there were 78 recurrences or deaths, and 53 patients died. The two groups were similar in terms of the risk of first event and death (hazard ratios 1.10 and 1.20, respectively) and five-year disease-free and overall survival rates (81 and 85.9 percent in the lymphadenectomy arm and 81.7 and 90 percent in the no-lymphadenectomy arm, respectively). However, a significantly greater percentage of lymphadenectomy patients had improved surgical staging due to a greater number of lymph node metastases being found (13.3 versus 3.2 percent).
"Although systematic pelvic lymphadenectomy statistically significantly improved surgical staging, it did not improve disease-free or overall survival," Panici and colleagues conclude.