The role of lymphadenectomy in surgical staging of endometrial cancer

Chang, Suk Joon; Ryu, Hee Sug

Abstract

A review of the role of lymph nodes dissection for patients with endometrial cancer was performed. The prognostic value of node status for endometrial cancer patients has been recognized, and lymph nodes dissection performed by experienced surgeons has acceptable morbidity. Multiple series have suggested that significantly less external beam radiation is given to patients with known negative nodes. In 1988 FIGO established the surgical staging system for endometrial cancer, ever since the decreased use of postoperative whole pelvic radiation has potential cost savings. However a survival advantage for lymph nodes dissection has not yet been proven in a randomized clinical trial. The interim result of ASTEC study showed that there is no survival advantage for endometrial cancer patients who undergo lymph nodes dissection. Although the morbidity, potential cost savings,and prognostic impact of node status are well accepted, it remains controversial as to whether lymph nodes dissection provides a survival advantage.