Pelvic versus pelvic and aortic lymphadenectomy in management of early stage endometrial cancer

ABSTRACT

The aim of this study was to assess the effect of the extent of selective lymphadenectomy [pelvic vs. pelvic and aortic] on morbidity and mortality in women with clinical stage I/IIA endometrial cancer. 27 patients with endometrial cancer who received primary surgical treatment from 1998 to 2004 were included in the study. Patients divided into two groups, first group 12 patients underwent hysterectomy, pelvic and aortic lymphadenectomy. Second groups15 patients underwent hysterectomy with pelvic lymphadenectomy only. Inclusion criteria were preoperative clinical stage I/IIA diseases. exclusion criteria included presurgical radiation, or extra uterine metastases at leparatomy. For comparison between two groups independent sample T test [unpaired T] and Pearson correlation test used. Median number of pelvic nodes removed was 13 [range 9 to 17 nodes], and median number of aortic nodes removed was 5 [range 3 to 9]. Pelvic node metastases were 18.5%. aortic lymph node metastasis was [8.33%] in aortic group. Medical adverse events observed in 13.33% of pelvic lymphadenectomy group and 20% has surgical adverse events, while 8.33% in group of pelvic and aortic lymphadenectomy has medical adverse events, and 33.33% has surgical adverse events. Mena anesthesia time was 197 m. for first group, while it is 229m. for the second group. Mean blood loss in first group was 540cc, while it is 799cc for the second group. Blood transfusion was given to two patients in first group and one unit of blood is given, while four patients in second group received blood transfusion, one of them received 2 units. Mean hospitals stay for the first group was 5 days, while it was 7 days for second group. There is no operative mortality for both groups. Aortic lymphadenectomy add to intraoperative morbidity but not increase postoperative morbidity or mortality. Because of increased operative morbidity the potential benefit of selective aortic lymphadenectomy should be weighed along with known prognostic factors and medical fitness in determining the suitability of individual patients for this procedure