RESUMO
PURPOSE: To study the value of pretreatment testing of P53 overexpression in selection of candidates for pelvic lymphadenectomy in clinical stage I endometrial carcinoma. PATIENTS AND METHODS: This prospective randomized clinical study included 38 patients with histologically confirmed endometrial carcinoma and staged clinically as stage I. Immunohistochemical staining of the tumor specimens obtained by dilatation and curettage with P53 monoclonal antibodies was done. The patients were randomized into two groups according to the planned surgical treatment: hysterectomy group and hysterectomy plus pelvic lymphadenectomy group. RESULTS: There was no significant difference in mean age, parity, medical status, surgical stage, histologic types, grade of differentiation, and myometrial invasion between the two groups. The survival rate in the hysterectomy group in our study was 82.4% and the recurrence rate was 17.6%, while in hysterectomy and lymphadenectomy group the survival rate was 81.0% and the recurrence rate was 19%. Adding pelvic lymphadenectomy was found to be associated with prolonged recurrence time in the P53-positive patients (24.07 vs. 17.8 months for group A). CONCLUSION: Pretreatment testing of P53 expression is recommended to help with other prognostic factors in the selection of candidates for pelvic lymphadenectomy in clinical stage I endometrial carcinoma.
