Background: Lymphadenectomy is part of surgical staging of endometrial cancer.Objective: To describe complications of lymphadenectomy.Materials and methods: Patients with endometrial adenocarcinomawhich underwent THBSO, were randomized to systematic pelvicþaortic lymphadenectomy (arm A) vs no lymphadenectomy/bulkynodes resection (arm B).Eligibility criteria were: age<75 yrs, BMI<35, informed consent.Exclusion criteria were: serous papillary and clear cell tumor, M0and G1M1 tumor, distant metastasis, ASA >3, Karnofsky<80.Results: From October 1996 to December 2003, 436 patients wererandomized from 26 partecipating centers. Among 347 evaluablepatients, 310 (89%) were considered eligible for this analysis (armA: 156, arm B: 154). Age, BMI, grade and myoinvasion were similarlydistributed in both arms. In arm A all patients underwentpelvic lymphadenectomy, while aortic was performed in 25, themedian number of nodes removed was: pelvic 34 (range 10—87)and aortic 23 (range 19—39), respectively. In arm B nodes wereremoved in 25 (16%) patients. Operating time and blood loss weresignificantly higher in arm A. No difference was observed fortransfusion rate, time to flatus and postoperative stay. Early andlate postoperative complications occurred in 26 (16%) and 24 (15%) of arm A patients, and in 10 (6%) and 12 (8%) of arm B patients (p<0.01).Conclusions: This study showed that systematic pelvic lymphadenectomy in endometrial cancer patients, significantly increased postoperative morbidity. These data should be taken in account when operating on an endometrial cancer patient with low risk for lymphatic metastasis.
Complications of lymphadenectomy in endometrial cancer. Results of a prospective randomized multicentric clinical trial.
FRANCHI, Massimo Piergiuseppe;
2004-01-01
Abstract
Background: Lymphadenectomy is part of surgical staging of endometrial cancer.Objective: To describe complications of lymphadenectomy.Materials and methods: Patients with endometrial adenocarcinomawhich underwent THBSO, were randomized to systematic pelvicþaortic lymphadenectomy (arm A) vs no lymphadenectomy/bulkynodes resection (arm B).Eligibility criteria were: age<75 yrs, BMI<35, informed consent.Exclusion criteria were: serous papillary and clear cell tumor, M0and G1M1 tumor, distant metastasis, ASA >3, Karnofsky<80.Results: From October 1996 to December 2003, 436 patients wererandomized from 26 partecipating centers. Among 347 evaluablepatients, 310 (89%) were considered eligible for this analysis (armA: 156, arm B: 154). Age, BMI, grade and myoinvasion were similarlydistributed in both arms. In arm A all patients underwentpelvic lymphadenectomy, while aortic was performed in 25, themedian number of nodes removed was: pelvic 34 (range 10—87)and aortic 23 (range 19—39), respectively. In arm B nodes wereremoved in 25 (16%) patients. Operating time and blood loss weresignificantly higher in arm A. No difference was observed fortransfusion rate, time to flatus and postoperative stay. Early andlate postoperative complications occurred in 26 (16%) and 24 (15%) of arm A patients, and in 10 (6%) and 12 (8%) of arm B patients (p<0.01).Conclusions: This study showed that systematic pelvic lymphadenectomy in endometrial cancer patients, significantly increased postoperative morbidity. These data should be taken in account when operating on an endometrial cancer patient with low risk for lymphatic metastasis.
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