G. Berclaz et al., Lymphadenectomy in high risk endometrial carcinoma stage I and II: no moremorbidity and no need for external pelvic radiation, INT J GYN C, 9(4), 1999, pp. 322-328
The objectives of this retrospective study were to analyze the morbidity of
surgical staging and to evaluate the omission of external radiotherapy in
high-risk patients with stage I and II endometrial carcinoma when the lymph
nodes were negative.
From 1988 to 1996, 63 of 117 patients underwent a pelvic and periaortic lym
phadenectomy. The decision to perform lymphadenectomy was influenced by pat
ient general health.
Patients with lymphadenectomy had a better physical status (P < 0.0001). Ly
mphadenectomy increased mean operative time (P < 0.0001) and blood loss (P
< 0.01), but there was no increase in postoperative complications. At a med
ian follow-up of 54 months, there was one cuff recurrence in 56 patients. N
ineteen high-risk patients without external pelvic radiation had the same d
isease-free survival rate as 37 low-risk patients (P = 0.1). In the group w
ithout lymphadenectomy, the disease-free survival for 18 high-risk patients
and 32 low-risk patients was similar (P = 0.21).
Surgical staging in properly selected patients does not increase postoperat
ive complications and brachytherapy without external radiotherapy is associ
ated with excellent disease-free survival when the lymph nodes are negative
.