Impact of lymphadenectomy on the treatment of endometrial cancer using data from the JSOG cancer registry

Saotome, Keiko; Yamagami, Wataru; Machida, Hiroko; Ebina, Yasuhiko; Kobayashi, Yoichi; Tabata, Tsutomu; Kaneuchi, Masanori; Nagase, Satoru; Enomoto, Takayuki; Aoki, Daisuke; Mikami, Mikio

doi:10.5468/ogs.20186

Cited by 8 publications

(8 citation statements)

References 14 publications

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“…In contrast, Saotome et al recently reported significantly better overall survival rates in patients who had undergone systematic lymph node dissection. However, the above mentioned study differed markedly from others in respect of group sizes (only 27% of all patients had no lymphadenectomy), age, and FIGO stages [34].…”

Section: Discussioncontrasting

confidence: 59%

Impact of lymphadenectomy on short- and long-term complications in patients with endometrial cancer

Proppe

Alkatout

Koch

et al. 2022

Arch Gynecol Obstet

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Introduction Early 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. Methods We collected data from 232 patients who were operated for endometrial carcinoma between 2006 and 2018 at the University of Lubeck, 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.

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Section: Discussioncontrasting

confidence: 59%

Impact of lymphadenectomy on short- and long-term complications in patients with endometrial cancer

Proppe

Alkatout

Koch

et al. 2022

Arch Gynecol Obstet

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show abstract

“…In contrast, Saotome et al recently reported signi cantly better overall survival rates in patients who had undergone systematic lymph node dissection. However, the above mentioned study differed markedly from others in respect of group sizes (only 27 % of all patients had no lymphadenectomy), age, and FIGO stages [33].…”

Section: Discussioncontrasting

confidence: 59%

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

Proppe

Alkatout

Koch

et al. 2021

Preprint

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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.

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“…Despite recent updates in the guidelines, many clinicians still do not feel comfortable replacing conventional LND with SLN mapping in high-risk patients. Additionally, the risk of lymph node metastasis was much higher in this cohort, as high as 20–30%, compared to the 5% observed in patients with low-risk subtype [ 11 – 13 ]. Furthermore, alternative lymphatic drainage, resulting in isolated para-aortic lymph node involvement is concerning [ 14 ].…”

Section: Introductionmentioning

confidence: 60%

Sentinel lymph node biopsy in high-risk endometrial cancer: performance, outcomes, and future avenues

Kim

2022

Obstet Gynecol Sci

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Endometrial cancer is the second most common gynecological malignancy worldwide, with an overall favorable prognosis. However, a subgroup of patients has a high risk of recurrence and poor prognosis. This review summarizes recently published articles that examined sentinel lymph node (SLN) biopsy in patients with high-risk endometrial cancer. We focused on the performance and outcomes of SLN biopsy, and examined potential methods for improving the management of this high-risk subset. Few studies have examined the long-term outcomes of SLN in patients with high-risk endometrial cancer.Thus, we reviewed recently published retrospective studies that have adopted statistical techniques, such as inverse probability weighting or propensity score matching, to examine the outcome of SLN biopsy compared to conventional lymphadenectomy. Potential avenues for future research to fine-tune decision making for this patient subgroup were also discussed.

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Impact of lymphadenectomy on the treatment of endometrial cancer using data from the JSOG cancer registry

Cited by 8 publications

References 14 publications

Impact of lymphadenectomy on short- and long-term complications in patients with endometrial cancer

Impact of lymphadenectomy on short- and long-term complications in patients with endometrial cancer

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

Sentinel lymph node biopsy in high-risk endometrial cancer: performance, outcomes, and future avenues

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