Pelvic Vs. Para-Aortic Lymphadenectomy For Patients With Type I Endometrial Cancer : a Comparison of Outcomes

Background. To compare surgery outcomes and prognosis of patients with type I endometrial cancer undergoing hysterectomy and bilateral salpingo-oophorectomy (H-BSO) with or without systematic pelvic lymphadenectomy or para-aortic lymphadenectomy. Methods. Patients with type I endometrial cancer undergoing H-BSO between January 2010 and June 2012 were comprehensively reviewed. Based on surgery extent, patients were divided into no-lymphadenectomy (PLD-/PALD-), systematic pelvic lymphadenectomy (PLD+/PALD-) or pelvic combined para-aortic lymphadenectomy (PLD+/PALD+). All patients received telephone follow-up. Surgery outcomes and prognosis were compared. Results. Total 333 patients met the inclusion criteria and 291 (87%) patients got effective follow-up data, 121 (36%) in PLD+/PALD-, 166 (49%) in PLD+/PALD+ and the remaining 46 (14%) in PLD-/PALD-. No significant difference was observed in the preoperative assessment among the three groups. According to surgery and pathology data, PLD+/PALD+ had higher laparotomy rate (P=0.001).Follow-up information indicated no difference in overall survival, and para-aortic lymphadenectomy was not a significant predictor. Conclusions. Utilization of para-aortic lymphadenectomy for type I endometrial cancer results in similar outcomes to H-BSO combined systematic pelvic lymphadenectomy. The benefit of para-aortic lymphadenectomy remains to be further discussed.