title: Diagnostic approach and therapeutic management in early-stage endometrial cancer.
abstract: OBJECTIVE
  The effectiveness of pelvic and para-aortic lymphadenectomy in the morbidity of patients affected by early-stage endometrial carcinoma (EC) is the subject of this study.
  
  
  METHODS
  Ninety-two cases with endometrial cancer that underwent para-aortic and pelvic lymphadenectomy, from June 1995 to June 2006, were studied and compared with 30 cases of patients with endometrial cancer without lymphadenectomy.
  
  
  RESULTS
  According to the results, systematic pelvic and para-aortic lymphadenectomies improved disease-free and overall survival rates among the patients with endometrial cancer. The mean number of removed para-aortic lymph nodes was 19.01 +/- 5.88, whereas the mean number of removed iliac lymph nodes was 32.94 +/- 6.69. Forty-two and 31 metastatic iliac and para-aortic nodes were found, respectively. No surgery-related deaths and major intraoperative injuries occurred. The frequency and the type of postoperative complications were not affected by the performance of lymphadenectomy. The morbidity rate was 6.2%, similar to the group without lymphadenectomy (5.79%). No recurrence occurred in the group with lymphadenectomy, while in the other group the recurrence rate was 23.3%.
  
  
  CONCLUSIONS
  Lymph nodes metastases can be observed in early stages of EC. Pelvic and para-aortic lymphadenectomies seems to provide profound information about the Stage of the disease and the patient's survival, identifying which patients are suitable for supplementary treatment, without significant clinical increase of morbidity.
authors.affiliation: Department of Obstetrics and Gynecology, Democritus University of Thrace, General Hospital of Alexandroupolis, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Koukoulomati
authors.forename: P
authors.initials: P
authors.lastname: Tsikouras
authors.forename: N
authors.initials: N
authors.lastname: Tsagias
authors.forename: R
authors.initials: R
authors.lastname: Csorba
authors.forename: A
authors.initials: A
authors.lastname: Liberis
authors.forename: A T
authors.initials: AT
authors.lastname: Teichmann
authors.forename: V S
authors.initials: VS
authors.lastname: Liberis
authors.forename: G
authors.initials: G
authors.lastname: Galazios
mesh_terms: D000328:Adult; D000368:Aged; D016889:Endometrial Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging