Role of systematic lymphadenectomy and adjuvant radiation in early-stage endometrioid uterine cancer.
OBJECTIVE
To determine the roles of lymphadenectomy in endometrioid uterine cancer patients and adjuvant radiation in early-stage endometrioid uterine cancer patients who underwent systematic lymphadenectomy.


METHODS
A retrospective analysis of 758 patients surgically treated for early-stage endometrioid uterine cancer from 2000 to 2006 was conducted. The primary outcome was 5-year overall survival in relation to systematic lymphadenectomy with or without adjuvant radiation.


RESULTS
Of the 758 patients, 547 (72.2%) underwent complete surgical staging, including systematic lymphadenectomy; adjuvant radiation was administered to 207 patients (27.3%). Within median follow-up of 35 months, systematic lymphadenectomy did not affect overall survival in early-stage patients (P = 0.4480). In the high-risk, early-stage group, however, the 5-year survival rate of the systematic lymphadenectomy group showed better survival compared with the no systematic lymphadenectomy group (P = 0.0095). Also, adjuvant radiation did not affect overall survival in early-stage patients (P = 0.1170), even in the group of high-risk, early-stage patients (P = 0.5680) who underwent systematic lymphadenectomy.


CONCLUSIONS
Systematic lymphadenectomy provided a survival benefit in high-risk endometrioid uterine cancer patients. However, in patients who underwent systematic lymphadenectomy, adjuvant radiation was not beneficial, even in high-risk patients.
Jeong
Nan-Hee
NH
Department of Obstetrics and Gynecology, School of Medicine, Kyung Hee University, Seoul, Korea.
Lee
Jong-Min
JM
Lee
Jae-Kwan
JK
Kim
Mi-Kyung
MK
Kim
Young-Jae
YJ
Cho
Chi-Heum
CH
Kim
Seok-Mo
SM
Park
Sang-Yoon
SY
Park
Chan-Yong
CY
Kim
Ki-Tae
KT
D000328:Adult; D000368:Aged; D018269:Carcinoma, Endometrioid / Q000473:pathology* / Q000532:radiotherapy* / Q000601:surgery; D016889:Endometrial Neoplasms / Q000473:pathology* / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008875:Middle Aged; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016019:Survival Analysis