OBJECTIVE: The objective of this study was to compare the initial failure sites in patients with endometrial cancer who underwent surgical treatment including pelvic lymphadenectomy with or without para-aortic lymphadenectomy. METHODS: A retrospective chart review was carried out for 657 endometrial cancer patients with no residual disease after initial treatments including lymphadenectomy at two tertiary centers between 1987 and 2004. Surgical treatment at one institute included pelvic lymphadenectomy (PLX) without para-aortic lymphadenectomy (PALX), while surgical treatment including PLX+PALX was routinely performed at the other institute. We identified patients with recurrence and evaluated initial failure sites. Rates of recurrence in the respective sites were compared according to the type of lymphadenectomy. RESULTS: Of the 657 patients, 103 (15.7%) suffered recurrence. There was no significant difference between the rate of intrapelvic recurrence in the PLX alone group and that in the PLX+PALX group (4.7% vs. 2.9%, p=0.22). The rate of extrapelvic recurrence in the PLX alone group was significantly higher than that in the PLX+PALX group (16.1% vs. 6.2%, p<0.0001), and the rate of para-aortic node (PAN) recurrence in the PLX alone group was also significantly higher than that in the PLX+PALX group (5.1% vs. 0.6%, p=0.0004). In the analysis of patients who received adjuvant chemotherapy, the rate of PAN recurrence in the PLX alone group was significantly higher than that in the PLX+PALX group (9.5% vs. 1.3%, p=0.0036). CONCLUSION: PAN recurrence was a failure pattern peculiar to the PLX alone group. Adjuvant chemotherapy might not be able to replace surgical removal as a treatment for metastatic lymph nodes.
OBJECTIVE: The objective of this study was to compare the initial failure sites in patients with endometrial cancer who underwent surgical treatment including pelvic lymphadenectomy with or without para-aortic lymphadenectomy. METHODS: A retrospective chart review was carried out for 657 endometrial cancerpatients with no residual disease after initial treatments including lymphadenectomy at two tertiary centers between 1987 and 2004. Surgical treatment at one institute included pelvic lymphadenectomy (PLX) without para-aortic lymphadenectomy (PALX), while surgical treatment including PLX+PALX was routinely performed at the other institute. We identified patients with recurrence and evaluated initial failure sites. Rates of recurrence in the respective sites were compared according to the type of lymphadenectomy. RESULTS: Of the 657 patients, 103 (15.7%) suffered recurrence. There was no significant difference between the rate of intrapelvic recurrence in the PLX alone group and that in the PLX+PALX group (4.7% vs. 2.9%, p=0.22). The rate of extrapelvic recurrence in the PLX alone group was significantly higher than that in the PLX+PALX group (16.1% vs. 6.2%, p<0.0001), and the rate of para-aortic node (PAN) recurrence in the PLX alone group was also significantly higher than that in the PLX+PALX group (5.1% vs. 0.6%, p=0.0004). In the analysis of patients who received adjuvant chemotherapy, the rate of PAN recurrence in the PLX alone group was significantly higher than that in the PLX+PALX group (9.5% vs. 1.3%, p=0.0036). CONCLUSION: PAN recurrence was a failure pattern peculiar to the PLX alone group. Adjuvant chemotherapy might not be able to replace surgical removal as a treatment for metastatic lymph nodes.
Authors: Brooke A Schlappe; Amy L Weaver; Jennifer A Ducie; Ane Gerda Zahl Eriksson; Sean C Dowdy; William A Cliby; Gretchen E Glaser; Robert A Soslow; Kaled M Alektiar; Vicky Makker; Nadeem R Abu-Rustum; Andrea Mariani; Mario M Leitao Journal: Gynecol Oncol Date: 2018-08-31 Impact factor: 5.482
Authors: A J Conde-Moreno; J L Lopez-Guerra; V A Macias; M L Vázquez de la Torre; P Samper Ots; S San José-Maderuelo; J Pastor Peidro; J López-Torrecilla; J Expósito-Hernández Journal: Clin Transl Oncol Date: 2015-09-02 Impact factor: 3.405
Authors: Janelle Pakish; Pamela T Soliman; Michael Frumovitz; Shannon N Westin; Kathleen M Schmeler; Ricardo Dos Reis; Mark F Munsell; Pedro T Ramirez Journal: Gynecol Oncol Date: 2013-12-20 Impact factor: 5.482
Authors: Petr Burkon; Iveta Selingerova; Marek Slavik; Petr Pospisil; Lukas Bobek; Libor Kominek; Pavel Osmera; Tomas Prochazka; Miroslav Vrzal; Tomas Kazda; Pavel Slampa Journal: Front Oncol Date: 2021-02-05 Impact factor: 6.244