Literature DB >> 17503431

Lymphadenectomy in endometrioid uterine cancer staging: how many lymph nodes are enough? A study of 11,443 patients.

John K Chan1, Renata Urban, Michael K Cheung, Jacob Y Shin, Amreen Husain, Nelson N Teng, Jonathan S Berek, Joan L Walker, Daniel S Kapp, Kathryn Osann.   

Abstract

BACKGROUND: The purpose of the current study was investigate the association between the number of lymph nodes examined and the probability of detecting at least a single lymph node involved by metastatic disease in patients with endometrioid corpus cancer.
METHODS: Demographic, clinicopathologic, and surgical information were obtained from the National Cancer Institute between 1990 and 2001. A logistic regression model was used to investigate the relation between the number of lymph nodes identified and the probability of detecting at least a single positive lymph node.
RESULTS: Of 11,443 patients, the median age was 64 years (range, 22-74 years). In all, 78.7% had stage I disease, 10.3% had stage II disease, and 11.0% had stage III disease; 31.5% had grade 1 histology, 40.6% had grade 2 histology, and 24.3% had grade 3 histology. The median number of lymph nodes reported was 9 (range, 1-90 lymph nodes). The median number of lymph nodes and the percent of patients with positive lymph nodes have increased from 1988 to 2001. An increasing number of lymph nodes removed was associated with a higher likelihood of identifying those with lymph node metastases. Based on the logistic regression model, the largest increase in probability of detecting at least a single positive lymph node was observed when 21 to 25 lymph nodes were resected (odds ratio [OR] of 1.45; 95% confidence interval [95% CI], 1.08-1.94 [P < .01]). Removing greater than 25 lymph nodes did not improve the statistical probability (OR of 1.23; 95% CI, 0.94-1.61 [P = .13]).
CONCLUSIONS: The current study data suggest that the removal of 21 to 25 lymph nodes significantly increases the probability of detecting at least 1 positive lymph node in endometrioid uterine cancer. The definition of an adequate lymphadenectomy deserves further investigation. Copyright 2007 American Cancer Society.

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Year:  2007        PMID: 17503431     DOI: 10.1002/cncr.22727

Source DB:  PubMed          Journal:  Cancer        ISSN: 0008-543X            Impact factor:   6.860


  17 in total

1.  Survival advantage of lymphadenectomy in endometrial cancer.

Authors:  Holm Eggemann; Tanja Ignatov; Katharina Kaiser; Elke Burger; Serban Dan Costa; Atanas Ignatov
Journal:  J Cancer Res Clin Oncol       Date:  2016-01-08       Impact factor: 4.553

2.  Nodal metastasis risk in endometrioid endometrial cancer.

Authors:  Michael R Milam; James Java; Joan L Walker; Daniel S Metzinger; Lynn P Parker; Robert L Coleman
Journal:  Obstet Gynecol       Date:  2012-02       Impact factor: 7.661

3.  The Futility of Systematic Lymphadenectomy in Early-Stage Low-grade Endometrial Cancer.

Authors:  Nidhi Nayyar; Prerna Lakhwani; Ashish Goel; Pankaj Kr Pande; Kapil Kumar
Journal:  Indian J Surg Oncol       Date:  2018-04-18

4.  Role of lymphadenectomy in the staging of endometrial cancer.

Authors:  Kimberly E Resnick; David E Cohn; Jeffrey M Fowler
Journal:  Nat Rev Clin Oncol       Date:  2009-07       Impact factor: 66.675

5.  Extent of lymphovascular space invasion may predict lymph node metastasis in uterine serous carcinoma.

Authors:  Yushen Qian; Erqi L Pollom; Chika Nwachukwu; Kira Seiger; Rie von Eyben; Ann K Folkins; Elizabeth A Kidd
Journal:  Gynecol Oncol       Date:  2017-07-11       Impact factor: 5.482

6.  Lymphovascular space invasion is an independent risk factor for nodal disease and poor outcomes in endometrioid endometrial cancer.

Authors:  Saketh R Guntupalli; Israel Zighelboim; Nora T Kizer; Qin Zhang; Matthew A Powell; Premal H Thaker; Paul J Goodfellow; David G Mutch
Journal:  Gynecol Oncol       Date:  2011-10-26       Impact factor: 5.482

7.  The impact of complete embedding of remaining tissue in gynecological lymph node dissection specimen in surgical pathology on lymph node yield: is it clinically relevant?

Authors:  Julia Andruszkow; Ivo Meinhold-Heerlein; Brigitte Winkler; Benjamin Bruno; Ruth Knüchel; Jörg Jäkel
Journal:  Virchows Arch       Date:  2018-04-28       Impact factor: 4.064

8.  Controversies in surgical staging of endometrial cancer.

Authors:  R Seracchioli; S Solfrini; M Mabrouk; C Facchini; N Di Donato; L Manuzzi; L Savelli; S Venturoli
Journal:  Obstet Gynecol Int       Date:  2010-06-23

9.  Robotic-assisted minimally invasive surgery for gynecologic and urologic oncology: an evidence-based analysis.

Authors: 
Journal:  Ont Health Technol Assess Ser       Date:  2010-12-01

10.  Impact of Lymph Node Ratio and Adjuvant Therapy in Node-Positive Endometrioid Endometrial Cancer.

Authors:  Nicole D Fleming; Pamela T Soliman; Shannon N Westin; Ricardo dos Reis; Mark Munsell; Ann H Klopp; Michael Frumovitz; Alpa M Nick; Kathleen Schmeler; Pedro T Ramirez
Journal:  Int J Gynecol Cancer       Date:  2015-10       Impact factor: 3.437

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