Whether complete lymphadenectomy is justified in high grade carcinoma of endometrium

Abstract

Author(s): Ramani Gangadharan Ashitha, Adarsh Dharmarajan, Aparna Vimal, Suganya Ganapathy

Background: Lymph node metastases are one of the most important prognostic factors in endometrial cancers. The objective of the study was to estimate incidence of nodal positivity in patients with high grade carcinoma endometrium.

Methods: Retrospective study of high-grade endometrial cancer patients who underwent curative treatment over a 6-year period. The nodal positivity was identified by a histology report. The nodal yield was determined by the number of nodes retrieved at the time of surgery. Pelvic and paraaortic nodal positivity was determined in high grade ca endometrium negative and the difference in overall survival among the patients with and without nodal positivity was determined.

Results: About 56 patients were involved in this analysis. Mean pelvic lymph node yield was 16.92 ± 5. 34 lymph nodes and mean paraaortic lymph node yield was 9.47 ± 3.78. The overall incidence of lymph node metastasis was 27% (15/56) in our study. Fourteen patients had pelvic lymph node metastasis, 6 (11.6%) patients with para-aortic lymph node metastasis and 1 (1.8%) patient had isolated para-aortic node metastasis. The overall survival of the study group for one year 98%and fourth year was 98% and 82.7% respectively. There were no differences in survival with respect to node positivity status (69.6 vs. 74.9 months, p=0.41).

Conclusion: Node positivity in high grade endometrial carcinoma was 27% and there were no differences in overall survival among the patients with nodal positivity. Routine assessment of nodal status for all patients with endometrial cancer shall guide in optimal staging and management

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