Survival Rates between Early Stage Endometrial Carcinoma With or Without Para-Aortic Lymph Node Resection

In 1988, the International Federation of Gynecology and Obstetrics (FIGO) introduced the concept of surgical staging of endometrial cancer. Pelvic lymph node resection is a part of our routine procedure for all endometrial cancer patients while the use of para-aortic lymph node resection is at the discretion of the physician during surgery.

To compare the survival rates of endometrial cancer patients receiving pelvic lymph node resection with patients receiving pelvic and para-aortic lymph node resection.

This was a retrospective cohort study of early stage endometrial cancer patients that underwent surgical staging with or without para-aortic lymph node resection. Eighty patients were in the only pelvic lymph node resection group (PLN group), and 284 patients were in the combined pelvic and para-aortic lymph node resection group (PPALN group). The survival data were analyzed using the Kaplan-Meier method, and the log-rank test was employed to compare the survival curves of the two groups.

The median follow-up period was 31.5 months. Median number of pelvic lymph nodes removed was 9 (1-33) for the PLN group and 14 (3-44) for the PPALN group. Median number of para-aortic nodes removed was 2 (0-12), and the rate of lymph node metastasis was 8.24%. In the PPALN group, 3.52% of patients had para-aortic lymph node metastasis. The overall 3- and 5-year survival rates were 90.9% and 87.4%, respectively for the PLN group as compared to 93.2% and 88.7% respectively for the PPALN group (p = 0.484).

The survival rate of early stage endometrial carcinoma patients that underwent surgical staging with or without para-aortic lymph node resection is comparable.