What is the role of pelvic and para-aortic lymphadenectomy in the treatment of endometrial carcinoma?

Updated: Jun 19, 2018
  • Author: William T Creasman, MD; Chief Editor: Warner K Huh, MD  more...
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Answer

The use of pelvic and para-aortic lymphadenectomy in the management of adenocarcinoma of the endometrium is controversial, as follows:

  • Whether the procedure aids in diagnosis is not in doubt. The question that has been raised is whether or not it also might be therapeutic. It certainly appears to be therapeutic for other gynecological cancers. Retrospective data by Kilgore and colleagues suggest that lymphadenectomy in endometrial cancer can also be therapeutic. [9]

  • The number of lymph nodes removed appears therapeutic even if positive nodes are present. In evaluating the SEER data, Chan has noted that patients with positive lymph nodes but few total nodes removed had a worse prognosis than if multiple nodes were removed. [10]

  • When proposed, the FIGO surgical staging classification was questioned as being efficacious by many investigators. However, data suggest that the gynecologic oncology community worldwide has accepted the surgical staging classification. In fact, lymphadenectomies are being performed routinely by these investigators.


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