Surgical staging for endometrial cancer in the elderly - is there a role for lymphadenectomy?

Gynecologic Oncology
William J LoweryLaura J Havrilesky

Abstract

We sought to evaluate the effect of systematic lymphadenectomy (LND) on endometrial cancer-specific survival in an elderly population. Data were obtained from the Surveillance, Epidemiology, and End Results (SEER) program from 1988 to 2006. Women who underwent primary hysterectomy for non-serous, non-clear cell endometrial carcinoma were included. Women were stratified by age (<70, 70-79, and ≥ 80) and disease-specific survival (DSS) was analyzed via the Kaplan-Meier method and stratified by postoperative grade. Cohorts were compared using the log-rank test. In a simulated population, the disease-specific survival of women with pre-operative grade 1 endometrial carcinoma was calculated using a weighted average survival accounting for those upgraded at final pathology. Endometrial cancer was identified in 5759 women ≥ 80 years old. Disease specific survival at 5 years for the LND and no LND groups was 93.4% and 94.5% (p=0.36) for grade 1, 84.4% and 85% (p=0.97) for grade 2, and 65.9% and 60.9% (p=0.002) for grade 3. In the simulated pre-operative grade 1 group, 5 year disease-specific survival (DSS) was 91% in the LND group and 92% in the no LND group. In women older than 80, systematic lymphadenectomy is associated with improve...Continue Reading

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Citations

Jan 22, 2015·Annals of Surgical Oncology·Jean-Luc BrunTristan Gauthier
May 8, 2015·International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society·Tomohito TanakaMasahide Ohmichi
Jan 6, 2018·International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society·Rami FaresNazem Shams
Jun 2, 2016·American Society of Clinical Oncology Educational Book·Linda DuskaMelanie Powell
Dec 10, 2015·Obstetrics and Gynecology·Jason D WrightDawn L Hershman
Jul 1, 2019·Archives of Gynecology and Obstetrics·Ling ZhaoJiali Luo
May 16, 2018·Menopause : the Journal of the North American Menopause Society·Meriem KoualAnne-Sophie Bats
Oct 23, 2020·Acta Obstetricia Et Gynecologica Scandinavica·Nasreen Hag-YahiaLimor Helpman

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