Low-risk corpus cancer: is lymphadenectomy or radiotherapy necessary?
OBJECTIVE
The objective of this study was to find readily ascertainable intraoperative pathologic indicators that would discriminate a subgroup of early corpus cancers that would not require lymphadenectomy or adjuvant radiotherapy.


METHODS
Between 1984 and 1993, a total of 328 patients with endometrioid corpus cancer, grade 1 or 2 tumor, myometrial invasion < or =50%, and no intraoperative evidence of macroscopic extrauterine spread were treated surgically. Pelvic lymphadenectomy was performed in 187 cases (57%), and nodes were positive in nine cases (5%). Adjuvant radiotherapy was administered to 65 patients (20%). Median follow-up was 88 months.


RESULTS
The 5-year overall cancer-related and recurrence-free survivals were 97% and 96%, respectively. Primary tumor diameter and lymphatic or vascular invasion significantly affected longevity. No patient with tumor diameter < or =2 cm had positive lymph nodes or died of disease.


CONCLUSIONS
Patients who have International Federation of Gynecology and Obstetrics grade 1 or 2 endometrioid corpus cancer with greatest surface dimension < or =2 cm, myometrial invasion < or =50%, and no intraoperative evidence of macroscopic disease can be treated optimally with hysterectomy only.
Mariani
A
A
Department of Obstetrics and Gynecology, Mayo Clinic and Mayo Foundation, Rochester, MN 55905, USA.
Webb
M J
MJ
Keeney
G L
GL
Haddock
M G
MG
Calori
G
G
Podratz
K C
KC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016889:Endometrial Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D008875:Middle Aged; D009215:Myometrium / Q000473:pathology; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local; D010388:Pelvis; D010537:Peritoneum / Q000473:pathology; D011183:Postoperative Complications; D011379:Prognosis; D011832:Radiation Injuries; D016019:Survival Analysis