&lt;p&gt;Differential Impact of Systemic Lymphadenectomy Upon the Survival of Patients with Type I vs Type II Endometrial Cancer: A Retrospective Observational Cohort Study&lt;/p&gt;

Xu, Jie; Chen, Can; Xiong, Jing; Linghu, Hua

doi:10.2147/cmar.s280780

Cited by 4 publications

(4 citation statements)

References 31 publications

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“…Xu et al evaluated, retrospectively, the effect of lymphadenectomy on survival rates in patients with (type I and type II) endometrial cancer. The authors aimed to determine the number of lymph nodes to be resected in order to achieve an overall survival bene t, and found no threshold for endometrioid endometrial carcinoma [30]. This is in line with our data, which indicated that systematic lymphadenectomy does not improve overall survival rates.…”

Section: Discussionsupporting

confidence: 83%

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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Section: Discussionsupporting

confidence: 83%

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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“…Scientifically, the impact of the extend of lymphadenectomy remains unclear. Recently, Xu et al reported no influence of the total number of resected lymph nodes on patient's survival, while other authors retrospectively pointed out a cutoff of > 10 nodes for a better survival [24,25]. The present study confirmed that patients with lymphadenectomy develop lymphatic complications significantly more often than those without lymphadenectomy (p < 0.01).…”

Section: Discussionsupporting

confidence: 80%

“…Xu et al evaluated, retrospectively, the effect of lymphadenectomy on survival rates in patients with (type I and type II) endometrial cancer. The authors aimed to determine the number of lymph nodes to be resected in order to achieve an overall survival benefit, and found no threshold for endometrioid endometrial carcinoma [24]. This is in line with our and the previously presented data, which indicate that the systematic lymphadenectomy does not improve overall survival rates.…”

Section: Discussionsupporting

confidence: 77%

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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“…Large retrospective studies have shown that lymphadenectomy is associated with longer overall survival, especially in high-risk endometrial cancer ( 63 ). Moreover, concerning type II endometrial cancer, one large retrospective study ( 64 ) showed that when >20 lymph nodes where removed there was an overall survival benefit and another retrospective study ( 65 ) demonstrated that systemic pelvic and paraaortic lymphadenectomy is a significant independent therapeutic factor that prolongs disease-free and overall survival. However, two large randomized control trials showed no statistically difference in disease-free and overall survival between lymphadenectomy or not ( 66 , 67 ).…”

Section: Lymph Nose Assessmentmentioning

confidence: 99%

Recent management of endometrial cancer: a narrative review of the literature

Pados,

Zouzoulas,

Tsolakidis

2024

Front. Med.

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Endometrial cancer is a common female gynecological neoplasia and its incidence rate has increased in the past years. Due to its predominant symptoms, most women will present uterine bleeding. It is usually diagnosed at an early stage and surgery has an important role in the treatment plan. The prognosis and quality of life of these patients can be quite favorable, if proper treatment is offered by surgeons. Traditionally, more invasive approaches and procedures were offered to these patients, but recent data suggest that more conservative and minimal invasive choices can be adopted in the treatment algorithm. Minimal invasive surgery, such as laparoscopy and robotic surgery, should be considered as an acceptable alternative, compared to laparotomy with less comorbidities and similar oncological and survival outcomes. Furthermore, sentinel lymph node biopsy has emerged in the surgical staging of endometrial cancer, in order to replace comprehensive lymphadenectomy. It is associated with less intra- and postoperative complications, while preliminary data show no difference in survival rates. However, sentinel lymph node biopsy should be offered within a strict algorithm, to avoid residual metastatic disease. The aim of this review is to analyze all the available data for the application of minimal invasive surgery in early endometrial cancer and especially the role of sentinel lymph node biopsy.

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<p>Differential Impact of Systemic Lymphadenectomy Upon the Survival of Patients with Type I vs Type II Endometrial Cancer: A Retrospective Observational Cohort Study</p>

Cited by 4 publications

References 31 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

Recent management of endometrial cancer: a narrative review of the literature

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