[Multi-institutional survey on the value of lymphadenectomy in endometrial carcinoma in Germany]

Primary surgical staging has been established in the management of carcinoma of the endometrium. Various working groups have also recommended the use of lymphadenectomy. Contrary to the prognostic relevance of lymph node status, the therapeutic value of lymphadenectomy is still unclear.

A total of 1,030 standardised questionnaires were sent to gynaecological clinics (including in-patient clinics) in Germany as part of a cross-sectional study between October 2001 and January 2002.

It was possible to evaluate 595 (58%) of the questionnaires from 5.2% university clinics, 69.7% clinics for maximal treatment and 25% clinics for regular therapy. Is a lymphadenectomy performed in the case of a carcinoma of the endometrium? Only 7.3%(95% Cl: 5.3-9.7%) reported that they never performed a lymphadenectomy, 62.9% (95% Cl: 58.9-66.9%) performed one in special cases, 29.7 (95% Cl: 26-33.7%) did so regularly. Which methods do you use for lymphadenectomy? 27.1% (95% Cl: 23.2-31.4%) used'sampling' and 72.9% (95% Cl 68.6-76.8%) used the technique of systematic removal. 26.6% lymph node dissections were both pelvic as well as para-aortic. What is your intention when performing a lymphadenectomy? 31.7% (95 Cl: 22.8-30.6%) performed it for stag-ing reasons, 3.1% (95% Cl: 1.8-4.9%) for the patient's survival and 65.2% (95% Cl: 60.9-69.3%) for both of these reasons. 94.5% (95% Cl:92.1-96.3%) said that the status of the affected lymph nodes influenced the choice of adjuvant treatment. 76.8% (95% Cl: 72.8-80.4%) and 36.9% (95% Cl: 46.9-56.5%) chose radiotherapy in stages I/II and III/IV, respectively; 20.4% (95% Cl: 16.9-24.2%) and 51.7%(95% Cl: 46.9-56.5%) chose radiochemotherapy.

The conception of prospective, multicentric studies of operative and adjuvant management should be based on these results.