Low-risk corpus cancer: Is lymphadenectomy or radiotherapy necessary?

Andrea Mariani, Maurice J. Webb, Gary L. Keeney, Michael G. Haddock, Giliola Calori, Karl C. Podratz

Research output: Contribution to journalArticlepeer-review

380 Scopus citations

Abstract

OBJECTIVE: The objective of this study was to find readily ascertainable intraoperative pathologic indicators that would discriminate a subgroup of early Corpus cancers that would not require lymphadenectomy or adjuvant radiotherapy. STUDY DESIGN: Between 1984 and 1993, a total of 328 patients with endometrioid corpus cancer, grade 1 or 2 tumor, myometrial invasion ≤50%, and no intraoperative evidence of macroscopic extrauterine spread were treated surgically. Pelvic lymphadenectomy was performed in 187 cases (57%), and nodes were positive in nine cases (5%). Adjuvant radiotherapy was administered to 65 patients (20%). Median follow-up was 88 months. RESULTS: The 5-year overall cancer-related and recurrence-free survivals were 97% and 96%, respectively. Primary tumor diameter and lymphatic or vascular invasion significantly affected longevity. No patient with tumor diameter ≤2 cm had positive lymph nodes or died of disease. CONCLUSION: Patients who have International Federation of Gynecology and Obstetrics grade 1 or 2 endometrioid corpus cancer with greatest surface dimension ≤2 cm, myometrial invasion ≤50%, and no intraoperative evidence of macroscopic disease can be treated optimally with hysterectomy only.

Original languageEnglish (US)
Pages (from-to)1506-1519
Number of pages14
JournalAmerican journal of obstetrics and gynecology
Volume182
Issue number6
DOIs
StatePublished - Jan 1 2000

Keywords

  • Endometrial cancer
  • Low-risk
  • Lymphadenectomy
  • Management
  • Radiotherapy

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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