The role of lymphadenectomy in endometrial cancer is controversial even if part of the International Federation of Gynecology and Obstetrics (FIGO) staging. FIGO guidelines recommend pelvic and para-aortic lymphadenectomy. Despite these recommendations, controversy continues to exist regarding the recommended extent of lymph node dissection, as well as its utility in improving survival for endometrial cancer. Recently two randomized clinical studies favored the "no-lymphadenectomy" arm. However a lot of criticisms have been raised, starting from the thoroughness of lymphadenectomy. Moreover, the introduction of the sentinel node technique brought other issues to the debate. Sentinel node detection will compete with emerging technologies such as MRI, PET-TC, and Molecular Markers in the identification of subset of patients eligible for lymph node dissection. Whether or not a complete (pelvic and aortic) lymphadenectomy is superior to the evolving technique of sentinel node is under debate. Up to date no definitive conclusions could be driven. Lymphadenectomy is not indicated in low-risk / negative nodes endometrial cancer. Lymphadenectomy seems to show therapeutic effects only in high-risk / positive nodes patients and could be used to tailor adjuvant therapies.
|Title of host publication||Endometrial Cancer: Prevention, Diagnosis and Treatment|
|Publisher||Nova Science Publishers, Inc.|
|Number of pages||12|
|Publication status||Published - Feb 2013|
ASJC Scopus subject areas
- Biochemistry, Genetics and Molecular Biology(all)