Thomas Papathemelis1, S Scharl2, K Kronberger3, M Gerken3, A Scharl4, A Pauer3, M Klinkhammer-Schalke3. 1. Frauenklinik, Klinikum St. Marien Amberg, Amberg, Germany. papathemelis.thomas@klinikum-amberg.de. 2. Klinik und Poliklinik für Strahlentherapie, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93051, Regensburg, Germany. 3. Tumorzentrum Regensburg, Institut für Qualitätssicherung und Versorgungsforschung der Universität Regensburg, Am Biopark 9, 93053, Regensburg, Germany. 4. Frauenklinik, Klinikum St. Marien Amberg, Amberg, Germany.
Abstract
OBJECTIVE: The standard therapy for high-grade endometrial cancer is surgery but the therapeutic effects of pelvic and paraaortic lymph node dissection (LND) are poorly investigated. In this study, we retrospectively evaluated overall survival, recurrence rates and recurrence-free survival among patients with high-grade type I and II endometrial carcinoma who underwent LND. METHODS: This study included 284 patients who are recorded in the German Tumor Centre Regensburg form 1998 to 2015 and were selected by cancer grading, the absence of secondary tumors, primary surgery including hysterectomy and available follow-up. 244 of the 284 patients in this cohort were unequivocally classified as R0 after resection. RESULTS: A significantly increased overall survival was observed for systematic LND of 25 or more paraaortic and pelvic lymph nodes versus patients who did not undergo such intervention (p < 0.001) or had elective LND of 1-24 lymph nodes both in univariable (p = 0.016) and multivariable (p = 0.014) analysis. A similar observation was made for recurrence-free survival of patients in the cohort who underwent complete tumor resection (R0). In addition, a reduced cumulative recurrence rate was observed for patients with systematic LND. CONCLUSIONS: Our study provides evidence that the systematic removal of 25 or more pelvic and paraaortic lymph nodes reduces the recurrence rate and that it is beneficial for the long-term overall and recurrence-free survival of patients with high-grade endometrial cancer.
OBJECTIVE: The standard therapy for high-grade endometrial cancer is surgery but the therapeutic effects of pelvic and paraaortic lymph node dissection (LND) are poorly investigated. In this study, we retrospectively evaluated overall survival, recurrence rates and recurrence-free survival among patients with high-grade type I and II endometrial carcinoma who underwent LND. METHODS: This study included 284 patients who are recorded in the German Tumor Centre Regensburg form 1998 to 2015 and were selected by cancer grading, the absence of secondary tumors, primary surgery including hysterectomy and available follow-up. 244 of the 284 patients in this cohort were unequivocally classified as R0 after resection. RESULTS: A significantly increased overall survival was observed for systematic LND of 25 or more paraaortic and pelvic lymph nodes versus patients who did not undergo such intervention (p < 0.001) or had elective LND of 1-24 lymph nodes both in univariable (p = 0.016) and multivariable (p = 0.014) analysis. A similar observation was made for recurrence-free survival of patients in the cohort who underwent complete tumor resection (R0). In addition, a reduced cumulative recurrence rate was observed for patients with systematic LND. CONCLUSIONS: Our study provides evidence that the systematic removal of 25 or more pelvic and paraaortic lymph nodes reduces the recurrence rate and that it is beneficial for the long-term overall and recurrence-free survival of patients with high-grade endometrial cancer.
Authors: Giorgio Bogani; Sean C Dowdy; William A Cliby; Fabio Ghezzi; Diego Rossetti; Andrea Mariani Journal: J Obstet Gynaecol Res Date: 2014-02 Impact factor: 1.730
Authors: Leszek Gottwald; Piotr Pluta; Janusz Piekarski; Michał Spych; Katarzyna Hendzel; Katarzyna Topczewska-Tylinska; Dariusz Nejc; Robert Bibik; Jerzy Korczyński; Aleksandra Ciałkowska-Rysz Journal: Arch Med Sci Date: 2010-12-29 Impact factor: 3.318
Authors: Thomas Papathemelis; Dunja Hassas; Michael Gerken; Monika Klinkhammer-Schalke; Anton Scharl; Michael P Lux; Mathias W Beckmann; Sophia Scharl Journal: J Cancer Res Clin Oncol Date: 2018-07-23 Impact factor: 4.553