RT journal article
T1 Role of lymphadenectomy in intermediate-risk endometrial cancer: a matched-pair study
A1 Coronado, Pluvio J
A1 Rychlik, Agnieszka
A1 Martínez-Maestre, Maria A.
A1 Baquedano, Laura
A1 Fasero, María
A1 García-Arreza, Aida
A1 Morales, Sara
A1 Lubián López, Daniel María
A1 Zapardiel, Ignacio
A2 Materno-Infantil y Radiología
K1 Endometrial Neoplasms
K1 Lymph Node Excision
K1 Costs and Cost Analysis
K1 Survival
K1 Risk Factors
K1 Morbidity
AB Objective: To assess the impact of lymph node dissection (LND) on morbidity, survival, and cost for intermediate-risk endometrial cancers (IREC).Methods: A multicenter retrospective cohort of 720 women with IREC (endometrioid histology with myometrial invasion <50% and grade 3; or myometrial invasion ≥50% and grades 1–2; or cervical involvement and grades 1–2) was carried out. All patients underwent hysterectomy and bilateral salpingo-oophorectomy. A matched pair analysis identified 178 pairs (178 with LND and 178 without it) equal in age, body mass index, co-morbidities, American Society of Anesthesiologist score, myometrial invasion, and surgical approach. Demographic data, pathology results, perioperative morbidity, and survival were abstracted from medical records. Disease-free survival (DFS) and overall survival (OS) was analyzed using Kaplan-Meier curves and multivariate Cox regression analysis. Cost analysis was carried out between both groups.Results: Both study groups were homogeneous in demographic data and pathologic results. The mean follow-up in patients free of disease was 61.7 months (range, 12.0–275.5). DFS (hazard ratio [HR]=1.34; 95% confidence interval [CI]=0.79–2.28) and OS (HR=0.72; 95% CI=0.42–1.23) were similar in both groups, independently of nodes count. In LND group, positive nodes were found in 10 cases (5.6%). Operating time and late postoperative complications were higher in LND group (p<0.05). Infection rate was significantly higher in no-LND group (p=0.035). There were no statistical differences between both groups regarding operative morbidity and hospital stay. The global cost was similar for both groups.Conclusion: Systematic LND in IREC has no benefit on survival, although it does not show an increase in perioperative morbidity or global cost.
PB Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology
SN 2005-0399
YR 2017
FD 2017-08-22
LK http://hdl.handle.net/10498/38395
UL http://hdl.handle.net/10498/38395
LA eng
DS Repositorio Institucional de la Universidad de Cádiz
RD 08-nov-2026