ADENOCARCINOMA OF THE ENDOMETRIUM - SURVIVAL COMPARISONS OF PATIENTS WITH AND WITHOUT PELVIC NODE SAMPLING

From 1969 to 1990, 649 patients with adenocarcinoma of the endometrium were surgically managed by gynecologic oncologists from the Universit y of Alabama at Birmingham. All patients underwent TAH-BSO and washing s. Two hundred twelve patients had multiple-site pelvic node sampling (mean number of nodes, 11), 205 patients had limited site pelvic node sampling (mean number of nodes, 4), and in 208 patients, nodes were no t sampled. Historical prognostic features, including tumor grade, dept h of invasion, adnexal metastasis, cervical involvement, and positive cytology, were equally distributed in the three groups. Mean follow-up was 3 years. Patients undergoing multiple-site pelvic node sampling h ad significantly better survival than patients without node sampling ( P = 0.0002). When patients were categorized as low risk (disease confi ned to the corpus) or as high risk (disease in the cervix, adnexa, ute rine serosa, or washings) multiple-site pelvic node sampling again pro vided a significant survival advantage compared to patients without no de sampling (high risk, P = 0.0006; low risk, P = 0.026). In a compari son of patients receiving whole pelvic radiation for grade III lesions or deep myometrial invasion, patients with multiple-site pelvic node sampling had better survival than those in whome nodes were not sample d (P = 0.0027). The significant survival advantage for patients having multiple-site node sampling, overall and in high- and low-risk groups , strongly suggests a therapeutic benefit. Additionally, adjuvant ther apy may be more appropriately directed in these patients. (C) 1995 Aca demic Press, Inc.