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

82 Citations (Scopus)

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
Pages (from-to)301-311
Number of pages11
JournalJournal of Obstetrics and Gynaecology Research
Volume40
Issue number2
DOIs
Publication statusPublished - 2014

Fingerprint

Endometrial Neoplasms
Lymph Node Excision
Morbidity
Postoperative Care
Gynecology
Patient Selection
Obstetrics
Quality of Life
Outcome Assessment (Health Care)
Radiation
Costs and Cost Analysis
Survival
Therapeutics
Pharmaceutical Preparations

Keywords

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

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

Role of pelvic and para-aortic lymphadenectomy in endometrial cancer : Current evidence. / Bogani, Giorgio; Dowdy, Sean C.; Cliby, William A.; Ghezzi, Fabio; Rossetti, Diego; Mariani, Andrea.

In: Journal of Obstetrics and Gynaecology Research, Vol. 40, No. 2, 2014, p. 301-311.

Research output: Contribution to journalArticle

Bogani, Giorgio ; Dowdy, Sean C. ; Cliby, William A. ; Ghezzi, Fabio ; Rossetti, Diego ; Mariani, Andrea. / Role of pelvic and para-aortic lymphadenectomy in endometrial cancer : Current evidence. In: Journal of Obstetrics and Gynaecology Research. 2014 ; Vol. 40, No. 2. pp. 301-311.
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