PELVIC LYMPHADENECTOMY IN HIGH-RISK ENDOMETRIAL CANCER

Two hundred and thirty-eight out of a total of 1012 patients with 'hig h risk' endometrial cancer underwent a complete pelvic lymphadenectomy . When the disease was confined to the corpus, the rate of node positi vity was 7%, when the cervix was involved it was 22% and with adnexal involvement was 52%. The recurrence rate with negative nodes was 14% c ompared to 45% with positive nodes. Age, menopausal status, histology and depth of invasion were predictors of survival after stratification by node status. Node status had no significant influence on site of r ecurrence. Women who underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy (TAH-BSO) and pelvic lymphadenectomy followed b y vaginal vault brachytherapy had a similar cancer-free survival to th ose treated by TAH-BSO alone, followed by adjuvant megavoltage therapy and vaginal vault brachytherapy.