Evaluation of pelvic lymph node dissection in endometrial carcinoma

ElAzab, Abdallah; Taher, Mohammad; Salama, Mohamed; Rashad, Nadhmi; Ezzat, Noha El-sayed; Abdelrahman, Ibrahim

doi:10.21608/jcbr.2023.203411.1299

	Evaluation of pelvic lymph node dissection in endometrial carcinoma
Egyptian Journal of Cancer and Biomedical Research
Volume 7, Issue 2, June 2023, Page 71-78 PDF (883.86 K)
Document Type: Original Article
DOI: 10.21608/jcbr.2023.203411.1299
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Authors
Abdallah ElAzab¹; Mohammad Taher ¹; Mohamed Salama¹; Nadhmi Rashad¹; Noha El-sayed Ezzat²; Ibrahim Abdelrahman¹
¹Surgical Oncology Department, National Cancer Institute - Cairo University, Cairo, Egypt
²Pathology Department (Cytopathology Unit), National Cancer Institute- Cairo University, Cairo, Egypt
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.
Keywords
Endometrial carcinoma; pelvic lymphadenectomy; para-aortic lymphadenectomy; extended lymphadenectomy


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