title: Dissection of unsuspicious para-aortic lymph nodes does not improve prognosis of advanced endometrial carcinoma with intra- or extra-abdominal metastasis.
abstract: BACKGROUND
  The aim of this study was to analyze the significance of dissection of unsuspicious para-aortic lymph nodes (PAN) in patients with advanced endometrial carcinomas with intra- or extra-abdominal metastasis.
  
  
  METHODS
  We conducted a retrospective comparison of the results of PAN dissection versus non-dissection for endometrial carcinomas with macroscopic metastatic lesions beyond the uterus (without significant swelling of the regional lymph nodes, including PAN), whose lesions were completely resected.
  
  
  RESULTS
  Disease-free survival and overall survival did not exhibit a significant difference between the two groups. Multivariate Cox proportional hazards analysis demonstrated that PAN dissection was not an independent prognostic factor for survival. The frequency of PAN involvement at the first recurrence did not differ between the two groups.
  
  
  CONCLUSIONS
  For advanced endometrial carcinomas with macroscopic metastatic lesions beyond the uterus, without significant swelling of regional lymph nodes, PAN dissection may be omitted without a significant adverse effect on prognosis and survival.
authors.affiliation: Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan. ZVF03563@nifty.ne.jp
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Ueda
authors.forename: Mika
authors.initials: M
authors.lastname: Okazawa
authors.forename: Takayuki
authors.initials: T
authors.lastname: Enomoto
authors.forename: Tomomi
authors.initials: T
authors.lastname: Egawa-Takata
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Kimura
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Yoshino
authors.forename: Masami
authors.initials: M
authors.lastname: Fujita
authors.forename: Yukinobu
authors.initials: Y
authors.lastname: Ohta
authors.forename: Shoji
authors.initials: S
authors.lastname: Kamiura
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kimura
mesh_terms: D000328:Adult; D000368:Aged; D001011:Aorta / Q000473:pathology*; D002277:Carcinoma / Q000175:diagnosis / Q000473:pathology*; D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000175:diagnosis / Q000473:pathology*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies