title: Survival impact of lymphadenectomy stratified by nodal metastatic probability in endometrial cancer.
abstract: BACKGROUND
  Our objective was to identify a subgroup of patients with early-stage endometrial cancer in whom lymphadenectomy was associated with enhanced survival based on the stratification of lymph node (LN) metastasis probability provided by a previously developed nomogram.
  
  
  METHODS
  Data from the Surveillance, Epidemiology, and End Results database for 66,210 patients with histologically proven endometrial cancer were analyzed. For each patient, the LN metastasis probability according to the previously developed nomogram was calculated. Patients were clustered into quintiles according to their LN metastasis probability. The cancer related survival in each quintile group was calculated using Kaplan-Meier analysis and compared based on whether patients underwent lymphadenectomy.
  
  
  RESULTS
  Except for the second quintile group, the specific survival rate systematically decreased when the predicted LN probability increased. In the five quintile groups, the 5-year specific survival rate was significantly higher in the patients who did not undergo lymphadenectomy compared with those who underwent lymphadenectomy and had ≥ 10 or <10 LNs removed.
  
  
  CONCLUSIONS
  Our results suggest the pejorative outcome associated with a higher risk of LN metastasis is not counterbalanced by the lymphadenectomy.
authors.affiliation: Department of Obstetrics and Gynecology, APHP Hôpital Bichat, Paris, France, martin.koskas@wanadoo.fr.
authors.forename: Martin
authors.initials: M
authors.lastname: Koskas
authors.forename: Marie
authors.initials: M
authors.lastname: Fournier
authors.forename: Dominique
authors.initials: D
authors.lastname: Luton
authors.forename: Emile
authors.initials: E
authors.lastname: Darai
authors.forename: Roman
authors.initials: R
authors.lastname: Rouzier
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000453:epidemiology / Q000401:mortality* / Q000556:secondary / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002291:Carcinoma, Papillary / Q000453:epidemiology / Q000401:mortality* / Q000556:secondary / Q000601:surgery; D002296:Carcinosarcoma / Q000453:epidemiology / Q000401:mortality* / Q000556:secondary / Q000601:surgery; D016022:Case-Control Studies; D018284:Cystadenocarcinoma, Serous / Q000453:epidemiology / Q000401:mortality* / Q000556:secondary / Q000601:surgery; D016889:Endometrial Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D008197:Lymph Node Excision / Q000401:mortality*; D008198:Lymph Nodes; D008207:Lymphatic Metastasis; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D049451:Nomograms; D011336:Probability; D011379:Prognosis; D011446:Prospective Studies; D018426:SEER Program; D015996:Survival Rate; D055815:Young Adult