Lymph node dissection in intermediate and high-intermediate risk endometrial cancer

Objective: The aim of this study was to assess the impact of lymph node dissection (LND) on survival for patients with intermediate risk (IR) and high intermediate risk (HIR) endometrial cancer (EC). Methods: Clinicopathologic features and survival data of 1294 consecutive patients who underwent primary surgical treatment for EC between 2003 and 2018 were retrieved from the database of Hacettepe University Hospital. This study compared the overall survival (OS) and disease-free survival (DFS) among IR and HIR EC between patients with LND and no LND. Results: The study population included 141 (55%) IR, and 115 (45%) HIR EC patients. LND was not performed in 33 (23.4%), and 31 (27%) patients in IR, and HIR EC patients, respectively. The lymph node involvement was 10.3% (n = 20) among all patients. During the median follow-up of 41 months (range, 12–222), 12 (6.2%) patients with LND, and 5 (7.8%) patients without LND had disease recurrence (p = 0.77). LND did not improve OS and DFS in IR and HIR EC patients (p = 0.92, p = 0.80). And the lymph node count was not associated with OS and DFS for all subsets of patients with EC grouped by recurrence risks. Conclusion: Without illuminating the morbidity of LND, there was no difference observed in OS and DFS between IR and HIR EC patients with LND-induced complications and no LND. With this regard, the LND can be omitted for minimizing the possible post-operative morbidities in this selected patient groups.

Endometrial cancer; Intermediate risk; High intermediate risk; Survival

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