title: Should all endometrioid uterine cancer patients undergo systemic lymphadenectomy?
abstract: OBJECTIVE
  To evaluate the potential benefits of systemic pelvic and para-aortic lymphadenectomy in endometrioid uterine cancer patients.
  
  
  METHODS
  We conducted a retrospective study on 244 cases of endometrioid uterine cancer that involved surgery in the Center of Gynecologic Oncology, Peking University People's Hospital, Beijing, from January 2000 to May 2008. We conducted staging for each case to ensure accordance with FIGO 2009 surgical staging criteria. Clinical data, including histology, age at diagnosis, surgical procedure, adjuvant therapy, date of death or last follow-up, and date and sites of recurrence were collected for each patient.
  
  
  RESULTS
  Among 244 endometrioid uterine cancer patients, 207 cases (84.8%) underwent systemic pelvic lymphadenectomy. Among these cases, pelvic lymph nodes in 17 cases (8.2%) exhibited tumor metastasis. Systemic aortic lymphadenectomy was performed in 127 cases (52.0%) among 244 total patients. Five cases (3.9%) exhibited positive aortic lymph nodes, of which four exhibited positive pelvic lymph nodes. We investigated the impact of positive retroperitoneal lymph nodes on staging: 4 (4/161, 2.5%), 6 (6/29, 20.7%), 6 (6/35, 17.1%), 1 (1/8) and 1 (1/6) case changed to stage IIIc from stage Ia, Ib, II, IIIa, and IIIb, respectively. Tumor-free and overall survival did not differ between patients who underwent pelvic lymphadenectomy or not (P > 0.05). Tumor-free survival improved in stage Ib pelvic lymphadenectomy patients (P = 0.040); para-aortic lymphadenectomy did not improve patient survival in all stages (P > 0.05).
  
  
  CONCLUSIONS
  Systemic lymphadenectomy is not warranted in stage Ia endometrioid uterine cancer.
authors: Center of Gynecologic Oncology, Peking University People's Hospital, No. 11 Xizhimen South Street, Beijing 100044, China.
authors: Z-Q
authors: ZQ
authors: Wang
authors: J-L
authors: JL
authors: Wang
authors: D-H
authors: DH
authors: Shen
authors: X-P
authors: XP
authors: Li
authors: L-H
authors: LH
authors: Wei
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018269:Carcinoma, Endometrioid / Q000453:epidemiology / Q000556:secondary / Q000601:surgery*; D002681:China / Q000453:epidemiology; D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects; D008207:Lymphatic Metastasis; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016019:Survival Analysis