Endometrial Cancer and the Role of Lymphadenectomy.
OBJECTIVE
The role of lymph node dissection in early-stage endometrial cancer is highly debated, but staging and prognosis are dependent on knowledge of lymph node metastasis.


OBJECTIVE
We sought to review the available data on the use of lymph node assessment in presumed early-stage endometrial cancer.


METHODS
A comprehensive literature review was performed using MEDLINE, the Cochrane Collaborative Database, and PubMed.


RESULTS
There is limited retrospective data that suggest a therapeutic benefit to lymphadenectomy. Prospective randomized trials have not shown a benefit to lymphadenectomy in low-risk patients, but found significant morbidity in patients undergoing lymphadenectomy. Selective lymph node assessment should be used in low-risk endometrial cancer. Sentinel lymph node assessment is emerging as a potential strategy for lymph node assessment.


CONCLUSIONS
Selective use of lymphadenectomy in early-stage endometrial cancer can reduce the morbidity associated with lymph node dissection without compromising clinical outcomes. Multiple strategies are available including sentinel lymph nodes and risk factor based lymphadenectomy.
Clinical Fellow.
Leslie H
LH
Clark
Professor, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC.
John T
JT
Soper
D016889:Endometrial Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects; D008207:Lymphatic Metastasis; D008209:Lymphedema / Q000209:etiology; D008279:Magnetic Resonance Imaging; D009367:Neoplasm Staging / Q000379:methods; D011379:Prognosis; D012307:Risk Factors; D000071036:Sentinel Lymph Node / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed