title: Survival analysis of pelvic lymphadenectomy alone versus combined pelvic and para-aortic lymphadenectomy in patients exhibiting endometrioid type endometrial cancer.
abstract: The therapeutic benefit of lymphadenectomy in patients exhibiting endometrial cancer (EC) remains controversial. The aim of the present study was to determine whether the addition of para-aortic lymphadenectomy to pelvic lymphadenectomy (PLND) improves survival in patients with endometrioid type EC. A single tertiary-center, retrospective analysis was conducted in a total of 186 patients who were surgically treated with either PLND alone (n=97) or combined pelvic and para-aortic lymphadenectomy (PPaLND; n=89). Adjuvant treatments were assigned according to the Gynecologic Oncology Group (GOG) risk of recurrence analysis. The primary endpoint of the present study was progression-free survival (PFS). The median follow-up time was 38 months (95% confidence interval, 36.47-42.90) for all patients. No statistically significant differences were identified between the two groups in terms of overall survival (OS), PFS or time to progression (TTP). Kaplan-Meier estimates of three-year OS, PFS and TTP for patients with low or low-intermediate risk were as follows: PLND, 100, 98.7 and 98.7%, respectively; and PPaLND, all 100%. The estimated three-year OS, PFS and TTP for patients with high or high-intermediate risk were as follows: PLND, 92.3, 81.3 and 81.3%; and PPaLND, 90.7, 77.1 and 80.9%, respectively. No statistically significant differences were detected in the three-year OS, PFS and TTP between the lymphadenectomy groups, regardless of the GOG risk of recurrence (PLND, 98.4, 95.3 and 95.3%; and PPaLND, 94.9, 87.1 and 89.4%). Therefore, the combination treatment, PPaLND did not provide any survival advantage over pelvic lymphadenectomy alone.
authors.affiliation: Department of Obstetrics and Gynaecology, Division of Gynaecologic Oncological Surgery, Akdeniz University Hospital, Antalya, Konyaaltı 07070, Turkey.
authors.forename: Tayfun
authors.initials: T
authors.lastname: Toptas
authors.affiliation: Department of Obstetrics and Gynaecology, Division of Gynaecologic Oncological Surgery, Akdeniz University Hospital, Antalya, Konyaaltı 07070, Turkey.
authors.forename: Tayup
authors.initials: T
authors.lastname: Simsek
keywords: endometrial cancer; endometrioid type; lymphadenectomy; survival