THE ROLE OF ROUTINE PELVIC LYMPH-NODE SAMPLING IN PATIENTS WITH STAGE-I ENDOMETRIAL CARCINOMA - 2ND THOUGHTS

Background and methods. The cases of 245 patients diagnosed during 198 0-1989 with stage I endometrial carcinoma were retrospectively reviewe d in order to assess the contribution of lymph node sampling (LNS) to both course of treatment and outcome. The 183 women treated by gyneco- oncologic surgeons had undergone the standard surgical procedure of to tal abdominal hysterectomy (TAH), bilateral salpingo-oophorectomy (BSO ) and pelvic lymph node sampling (LNS). Sixty-two other women, treated by gynecologists, received only TAH and BSO. Of women who had receive d TAH+BSO+LNS, 105 (57.4%) were referred for adjuvant radiotherapy on the basis of one or any combination of high grade histology (G2 or G3) , myometrial invasion to a depth of 50% or more and LNS positivity. Of the group who had not had LNS, 37 (59.7%) likewise received adjuvant radiotherapy but on the bases of histology and/or depth of invasion. R esults and conclusions. Recurrence and survival over a mean follow-up period of 7.5 years (range 5-15 years) showed no significant differenc es between the patients who underwent LNS and those who did not. Of 43 recurrences, six were among 'low risk' women (those with both minimal invasion and low grade histology), suggesting a special need among th is group for the additional staging information which LNS may provide.