Role of pelvic and para-aortic lymphadenectomy in endometrial cancer: Current evidence

Giorgio Bogani, Sean C. Dowdy, William A. Cliby, Fabio Ghezzi, Diego Rossetti, Andrea Mariani

Research output: Contribution to journalArticle

100 Scopus citations

Abstract

The aim of the present review is to summarize the current evidence on the role of pelvic and para-aortic lymphadenectomy in endometrial cancer. In 1988, the International Federation of Obstetrics and Gynecology recommended surgical staging for endometrial cancer patients. However, 25 years later, the role of lymph node dissection remains controversial. Although the findings of two large independent randomized trials suggested that pelvic lymphadenectomy provides only adjunctive morbidity with no clear influence on survival outcomes, the studies have many pitfalls that limit interpretation of the results. Theoretically, lymphadenectomy may help identify patients with metastatic dissemination, who may benefit from adjuvant therapy, thus reducing radiation-related morbidity. Also, lymphadenectomy may eradicate metastatic disease. Because lymphatic spread is relatively uncommon, our main effort should be directed at identifying patients who may potentially benefit from lymph node dissection, thus reducing the rate of unnecessary treatment and associated morbidity. This review will discuss the role of lymphadenectomy in endometrial cancer, focusing on patient selection, extension of the surgical procedure, postoperative outcomes, quality of life and costs. The need for new surgical studies and efficacious systemic drugs is recommended.

Original languageEnglish (US)
Pages (from-to)301-311
Number of pages11
JournalJournal of Obstetrics and Gynaecology Research
Volume40
Issue number2
DOIs
StatePublished - Feb 2014

Keywords

  • Aortic lymphadenectomy
  • Endometrial cancer
  • Pelvic lymphadenectomy
  • Staging
  • Survival

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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