Effectiveness of postoperative chemotherapy for para-aortic lymph node metastasis of endometrial cancer.
OBJECTIVE
To examine the effectiveness of postoperative chemotherapy for para-aortic lymph node (PAN) metastasis in patients with endometrial cancer.


METHODS
Among 350 clinical stage I-II endometrial cancer patients who underwent systemic pelvic and para-aortic lymphadenectomy during the period 1995 through 2002, 26 patients were identified with PAN metastasis. Of these patients, nine had only one positive PAN and 17 had two or more positive PANs (mean 4.9, range 1-22). All patients were treated postoperatively with a single chemotherapy regimen consisting of ifosfamide, epiadriamycin, and cisplatin scheduled for 5 cycles. Median (range) follow-up for surviving patients was 85 (38-119) months. Treatment outcome, including disease-free survival relative to the number of positive PANs, was investigated.


RESULTS
Among the 26 patients with PAN involvement, four developed recurrence. Three of the four patients had 10 or more positive PANs. Estimated 5-year disease-free survival rates were 89% for patients with one positive PAN, 82% for those with two or more positive PANs, and 85% for all patients. No significant difference was identified between the first two groups (P = 0.6543).


CONCLUSIONS
Postoperative chemotherapy can yield a favorable outcome in endometrial cancer patients with PAN metastasis, even those with multiple positive nodes.
Takeshima
Nobuhiro
N
Department of Gynecology, Cancer Institute Hospital, 3-10-6 Ariake, Koto-ku, Tokyo 135-8550, Japan. nobuhiro.takeshima@ifcr.or.jp
Umayahara
Kenji
K
Fujiwara
Kiyoshi
K
Hirai
Yasuo
Y
Takizawa
Ken
K
Hasumi
Katsuhiko
K
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D001011:Aorta; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage; D016889:Endometrial Neoplasms / Q000188:drug therapy* / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D010052:Ovariectomy; D016896:Treatment Outcome
D004317:Doxorubicin; D003520:Cyclophosphamide; D002945:Cisplatin