Impact of Lymphadenectomy on Short- and Long-term Complications in Patients With Endometrial Cancer

Abstract

IntroductionEarly endometrial cancer is primarily treated surgically via hysterectomy, adenectomy and, depending on tumor stage and subtype, lymphadenectomy. Systematic lymph node dissection is known to cause surgical complications. The aim of the present study was to investigate morbidity and mortality rates associated with lymphadenectomy in patients with endometrial cancer who underwent surgery in a routine clinical setting.MethodsWe collected data from 232 patients who were operated for endometrial carcinoma between 2006 and 2018 at the University of Luebeck, Germany. Surgical complications were viewed in relation to surgical risk factors. Additionally, a questionnaire concerning long-term lymphatic complications and survival was completed. Survival was compared between patients who underwent lymphadenectomy (group I) and those who did not (group II). Results Patients in group I needed revision surgery significantly more often due to postoperative complications (such as lymphoceles) compared to those in group II (p = 0.01). The results indicate more serious complications in patients who underwent a systematic lymphadenectomy and in those with lymph node metastases.15 % of patients who underwent a systematic lymphadenectomy had lymph node metastases. Recurrences occurred in 12.5 % of cases and were significantly more frequent in patients who had undergone a lymphadenectomy, even if the lymph nodes were negative (p = 0.02). A comparison of survival data during the follow-up period revealed no significant difference.The study highlighted the need for a better preoperative risk stratification and the avoidance of lymphadenectomy for surgical staging alone.

Evaluation of pelvic lymph node dissection in endometrial carcinoma

“…Lymphatic complications were found in 14 (6.6%), 2 (0.9%) of the lymphadenectomy, and no lymphadenectomy groups with a p-value of 0.004. Drains output median discharge daily in ml was 2385±3337, and 250.3±269.2 in the lymphadenectomy and no lymphadenectomy groups respectively (Proppe et al 2022).…”