In patients at risk of recurrence, pelvic and para-aortic lymphadenectomy cuts mortality odds

-- Jane Parry

Thursday, February 25, 2010 (Last Updated: 02/26/2010)

THURSDAY, Feb. 25 (HealthDay News) -- In endometrial cancer patients at high risk of recurrence, combined pelvic and para-aortic lymphadenectomy reduces the risk of recurrence significantly better than systemic pelvic lymphadenectomy, according to a study published online Feb. 25 in The Lancet.

Yukiharu Todo, M.D., of the Hokkaido Cancer Center in Sapporo, Japan, and colleagues conducted a study of 671 endometrial cancer patients, of whom 325 underwent complete systemic pelvic lymphadenectomy and 346 underwent combined pelvic and para-aortic lymphadenectomy, with radiotherapy and chemotherapy offered to patients at intermediate or high risk of recurrence.

In the pelvic and para-aortic lymphadenectomy group, overall survival was substantially longer than in the pelvic lymphadenectomy group (hazard ratio, 0.53), but there was no difference discerned between the groups in overall survival for low-risk patients, the investigators found. However, for patients at intermediate or high risk of recurrence, there was a lower risk of death after combined pelvic and para-aortic lymphadenectomy than after pelvic lymphadenectomy (hazard ratio, 0.44), the researchers found.

"The therapeutic significance of combined pelvic and para-aortic lymphadenectomy for patients with endometrial cancer is a matter of great debate," the authors write. "Our results have suggested that the survival effect of lymphadenectomy is restricted in low-risk patients; however, in patients of intermediate or high risk, complete, systematic lymphadenectomy in both the pelvic and para-aortic regions has substantial therapeutic effects."

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