title: Outcome of endometrial cancer after lymphadenectomy: a single center retrospective analysis with long-lasting follow-up.
abstract: BACKGROUND
  Role of lymphadenectomy in endometrial cancer is unclear. Our objective is to assess the role of lymphadenectomy in endometrial cancer.
  
  
  METHODS
  The study reviewed retrospectively 829 cases of endometrial cancer from a single non-oncological center from 1981 to 2014. Multivariable Cox regression analyses were performed. Independent variables were: 2009 FIGO stage, histological type of endometrial cancer (non-endometrioid, endometrioid, grading 1, 2 and 3), radicality on parametria, lymphatic dissection (any kind) (yes/no), any kind of chemotherapy, any kind of radiotherapy, brachytherapy, patients' age. Dependent variable was death for endometrial cancer and first relapse. Time variable was the semester of follow-up. P value for significance was set <0.05.
  
  
  RESULTS
  Many data about the extension of node dissection were missing. Pelvic node dissection or sampling seem the more common procedure performed. At the 10-semester of follow-up, at the 20-semester of follow-up and at the 30 semester of follow up, lymphadenectomy does not improve overall survival at a p value of less than 0.05. Lymphadenectomy reduces the risk of relapse at the 10 semester and 20-semester of follow-up.
  
  
  CONCLUSIONS
  Lymphadenectomy plays a role in preventing relapses but it is not proved that non-aggressive lymphadenectomy in endometrial cancer improves overall survival at p level of 0.05. Therefore, it cannot be excluded that a very small improvement in long lasting survival in few cases of endometrial cancer could be due to node dissections.
authors.affiliation: Section of Obstetrics and Gynecology, Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Cona, Ferrara, Italy.
authors.forename: Pantaleo
authors.initials: P
authors.lastname: Greco
authors.affiliation: Section of Obstetrics and Gynecology, Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Cona, Ferrara, Italy.
authors.forename: Ruby
authors.initials: R
authors.lastname: Martinello
authors.affiliation: Unit of Obstetrics and Gynecology, Alto Tevere Hospital of Città di Castello, Città di Castello, Perugia, Italy.
authors.forename: Ugo
authors.initials: U
authors.lastname: Indraccolo
authors.affiliation: Section of Obstetrics and Gynecology, Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Cona, Ferrara, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Borghi
authors.affiliation: Section of Obstetrics and Gynecology, Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Cona, Ferrara, Italy.
authors.forename: Gloria
authors.initials: G
authors.lastname: Bonaccorsi
authors.affiliation: Section of Obstetrics and Gynecology, Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Cona, Ferrara, Italy - g.scutiero@hotmail.com.
authors.forename: Gennaro
authors.initials: G
authors.lastname: Scutiero
mesh_terms: D000368:Aged; D016889:Endometrial Neoplasms / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000517:prevention & control; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors