Selective lymphadenectomy in endometrial cancer: Retrospective analysis of morbidity and survival data at a tertiary care centre
Identifieur interne : 007978 ( Ncbi/Merge ); précédent : 007977; suivant : 007979Selective lymphadenectomy in endometrial cancer: Retrospective analysis of morbidity and survival data at a tertiary care centre
Auteurs : Uzma Chishti [Pakistan] ; Aliya B. Aziz [Pakistan] ; Munazza Akhtar [Pakistan] ; Sana SheikhSource :
- Pakistan Journal of Medical Sciences [ 1682-024X ] ; 2015.
Abstract
To compare perioperative morbidity and survival data between patients with early-stage endometrial cancer who did or did not undergo selective lymphadenectomy.
Retrospective analysis of 180 patients with early-stage endometrial carcinoma treated between 1999 and 2008 was performed in Aga Khan University Hospital, Karachi, Pakistan.
Data from 180 patients were analysed. The selective lymphadenectomy group contained 108 women (60%) and the no lymphadenectomy group contained 72 women (40%). The median number of lymph nodes removed was 9. The mean age and extent of disease, as assessed by staging, tumour size, myometrial invasion, and lymphovascular invasion were comparable between groups. Upstaging of the disease to stage 3 and 4 occurred in 11% of patients in the lymphadenectomy group. There were no significant differences in the medical or surgical complications between groups. At a median follow-up of 26 months, both groups had comparable survival (lymphadenectomy versus no lymphadenectomy: 34 versus 32 months). Similar survival was noted for patients who underwent the removal of more or less than 5 pelvic lymph nodes.
Selective lymphadenectomy offers the advantage of improved surgical staging but no therapeutic benefit in terms of overall survival.
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DOI: 10.12669/pjms.314.7593
PubMed: 26430436
PubMed Central: 4590357
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Aziz, Assistant Professor, Department of Obstetrics and Gynaecology, Aga Khan University Hospital, Karachi, Pakistan</nlm:aff><country xml:lang="fr">Pakistan</country><wicri:regionArea>Dr. Aliya B. Aziz, Assistant Professor, Department of Obstetrics and Gynaecology, Aga Khan University Hospital, Karachi</wicri:regionArea><wicri:noRegion>Karachi</wicri:noRegion></affiliation></author><author><name sortKey="Akhtar, Munazza" sort="Akhtar, Munazza" uniqKey="Akhtar M" first="Munazza" last="Akhtar">Munazza Akhtar</name><affiliation wicri:level="1"><nlm:aff id="aff3">Dr. Munazza Akhtar, Senior Instructor, Department of Obstetrics and Gynaecology, Aga Khan University Hospital, Karachi, Pakistan</nlm:aff><country xml:lang="fr">Pakistan</country><wicri:regionArea>Dr. Munazza Akhtar, Senior Instructor, Department of Obstetrics and Gynaecology, Aga Khan University Hospital, Karachi</wicri:regionArea><wicri:noRegion>Karachi</wicri:noRegion></affiliation></author><author><name sortKey="Sheikh, Sana" sort="Sheikh, Sana" uniqKey="Sheikh S" first="Sana" last="Sheikh">Sana Sheikh</name><affiliation><nlm:aff>NONE</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">26430436</idno><idno type="pmc">4590357</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4590357</idno><idno type="RBID">PMC:4590357</idno><idno type="doi">10.12669/pjms.314.7593</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">000845</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000845</idno><idno type="wicri:Area/Pmc/Curation">000845</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000845</idno><idno type="wicri:Area/Pmc/Checkpoint">000E81</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000E81</idno><idno type="wicri:Area/Ncbi/Merge">007978</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Selective lymphadenectomy in endometrial cancer: Retrospective analysis of morbidity and survival data at a tertiary care centre</title><author><name sortKey="Chishti, Uzma" sort="Chishti, Uzma" uniqKey="Chishti U" first="Uzma" last="Chishti">Uzma Chishti</name><affiliation wicri:level="1"><nlm:aff id="aff1">Dr. Uzma Chishti, Senior Instructor, Department of Obstetrics and Gynaecology, Aga Khan University Hospital, Karachi, Pakistan</nlm:aff><country xml:lang="fr">Pakistan</country><wicri:regionArea>Dr. Uzma Chishti, Senior Instructor, Department of Obstetrics and Gynaecology, Aga Khan University Hospital, Karachi</wicri:regionArea><wicri:noRegion>Karachi</wicri:noRegion></affiliation></author><author><name sortKey="Aziz, Aliya B" sort="Aziz, Aliya B" uniqKey="Aziz A" first="Aliya B." last="Aziz">Aliya B. Aziz</name><affiliation wicri:level="1"><nlm:aff id="aff2">Dr. Aliya B. Aziz, Assistant Professor, Department of Obstetrics and Gynaecology, Aga Khan University Hospital, Karachi, Pakistan</nlm:aff><country xml:lang="fr">Pakistan</country><wicri:regionArea>Dr. Aliya B. Aziz, Assistant Professor, Department of Obstetrics and Gynaecology, Aga Khan University Hospital, Karachi</wicri:regionArea><wicri:noRegion>Karachi</wicri:noRegion></affiliation></author><author><name sortKey="Akhtar, Munazza" sort="Akhtar, Munazza" uniqKey="Akhtar M" first="Munazza" last="Akhtar">Munazza Akhtar</name><affiliation wicri:level="1"><nlm:aff id="aff3">Dr. Munazza Akhtar, Senior Instructor, Department of Obstetrics and Gynaecology, Aga Khan University Hospital, Karachi, Pakistan</nlm:aff><country xml:lang="fr">Pakistan</country><wicri:regionArea>Dr. Munazza Akhtar, Senior Instructor, Department of Obstetrics and Gynaecology, Aga Khan University Hospital, Karachi</wicri:regionArea><wicri:noRegion>Karachi</wicri:noRegion></affiliation></author><author><name sortKey="Sheikh, Sana" sort="Sheikh, Sana" uniqKey="Sheikh S" first="Sana" last="Sheikh">Sana Sheikh</name><affiliation><nlm:aff>NONE</nlm:aff></affiliation></author></analytic><series><title level="j">Pakistan Journal of Medical Sciences</title><idno type="ISSN">1682-024X</idno><idno type="eISSN">1681-715X</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="st1"><title>Objective:</title><p>To compare perioperative morbidity and survival data between patients with early-stage endometrial cancer who did or did not undergo selective lymphadenectomy.</p></sec><sec id="st2"><title>Methods:</title><p>Retrospective analysis of 180 patients with early-stage endometrial carcinoma treated between 1999 and 2008 was performed in Aga Khan University Hospital, Karachi, Pakistan.</p></sec><sec id="st3"><title>Results:</title><p>Data from 180 patients were analysed. The selective lymphadenectomy group contained 108 women (60%) and the no lymphadenectomy group contained 72 women (40%). The median number of lymph nodes removed was 9. The mean age and extent of disease, as assessed by staging, tumour size, myometrial invasion, and lymphovascular invasion were comparable between groups. Upstaging of the disease to stage 3 and 4 occurred in 11% of patients in the lymphadenectomy group. There were no significant differences in the medical or surgical complications between groups. At a median follow-up of 26 months, both groups had comparable survival (lymphadenectomy versus no lymphadenectomy: 34 versus 32 months). Similar survival was noted for patients who underwent the removal of more or less than 5 pelvic lymph nodes.</p></sec><sec id="st4"><title>Conclusion:</title><p>Selective lymphadenectomy offers the advantage of improved surgical staging but no therapeutic benefit in terms of overall survival.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="James, M" uniqKey="James M">M James</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Cragun, Jm" uniqKey="Cragun J">JM Cragun</name></author><author><name sortKey="Havrilesky, Lj" uniqKey="Havrilesky L">LJ Havrilesky</name></author><author><name sortKey="Calingaert, B" uniqKey="Calingaert B">B Calingaert</name></author><author><name sortKey="Synan, I" uniqKey="Synan I">I Synan</name></author><author><name sortKey="Secord, Aa" uniqKey="Secord A">AA Secord</name></author><author><name sortKey="Soper, Jt" uniqKey="Soper J">JT 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Pak J Med Sci</journal-id><journal-id journal-id-type="iso-abbrev">Pak J Med Sci</journal-id><journal-id journal-id-type="publisher-id">PJMS</journal-id><journal-title-group><journal-title>Pakistan Journal of Medical Sciences</journal-title></journal-title-group><issn pub-type="ppub">1682-024X</issn><issn pub-type="epub">1681-715X</issn><publisher><publisher-name>Professional Medical Publications</publisher-name><publisher-loc>Pakistan</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">26430436</article-id><article-id pub-id-type="pmc">4590357</article-id><article-id pub-id-type="publisher-id">PJMS-31-950</article-id><article-id pub-id-type="doi">10.12669/pjms.314.7593</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject></subj-group></article-categories><title-group><article-title>Selective lymphadenectomy in endometrial cancer: Retrospective analysis of morbidity and survival data at a tertiary care centre</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Chishti</surname><given-names>Uzma</given-names></name><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Aziz</surname><given-names>Aliya B.</given-names></name><xref ref-type="aff" rid="aff2">2</xref><xref ref-type="corresp" rid="cor1"></xref></contrib><contrib contrib-type="author"><name><surname>Akhtar</surname><given-names>Munazza</given-names></name><xref ref-type="aff" rid="aff3">3</xref></contrib><contrib contrib-type="author"><name><surname>Sheikh</surname><given-names>Sana</given-names></name><xref ref-type="aff" rid="aff3">4</xref></contrib></contrib-group><aff id="aff1"><label>1</label>Dr. Uzma Chishti, Senior Instructor, Department of Obstetrics and Gynaecology, Aga Khan University Hospital, Karachi, Pakistan</aff><aff id="aff2"><label>2</label>Dr. Aliya B. Aziz, Assistant Professor, Department of Obstetrics and Gynaecology, Aga Khan University Hospital, Karachi, Pakistan</aff><aff id="aff3"><label>3</label>Dr. Munazza Akhtar, Senior Instructor, Department of Obstetrics and Gynaecology, Aga Khan University Hospital, Karachi, Pakistan</aff><author-notes><corresp id="cor1">Correspondence: Dr. Aliya B. Aziz, Assistant Professor, Department of Obstetrics and Gynaecology, Aga Khan University Hospital, Karachi, Pakistan. E-mail: <email xlink:href="aliya.aziz@aku.edu">aliya.aziz@aku.edu</email></corresp></author-notes><pub-date pub-type="ppub"><season>Jul-Aug</season><year>2015</year></pub-date><volume>31</volume><issue>4</issue><fpage>950</fpage><lpage>955</lpage><history><date date-type="received"><day>02</day><month>3</month><year>2015</year></date><date date-type="rev-recd"><day>20</day><month>4</month><year>2015</year></date><date date-type="accepted"><day>28</day><month>4</month><year>2015</year></date></history><permissions><copyright-statement>Copyright: © Pakistan Journal of Medical Sciences</copyright-statement><copyright-year>2015</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/3.0"><license-p><pmc-comment>CREATIVE COMMONS</pmc-comment>This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/3.0">http://creativecommons.org/licenses/by/3.0</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><sec id="st1"><title>Objective:</title><p>To compare perioperative morbidity and survival data between patients with early-stage endometrial cancer who did or did not undergo selective lymphadenectomy.</p></sec><sec id="st2"><title>Methods:</title><p>Retrospective analysis of 180 patients with early-stage endometrial carcinoma treated between 1999 and 2008 was performed in Aga Khan University Hospital, Karachi, Pakistan.</p></sec><sec id="st3"><title>Results:</title><p>Data from 180 patients were analysed. The selective lymphadenectomy group contained 108 women (60%) and the no lymphadenectomy group contained 72 women (40%). The median number of lymph nodes removed was 9. The mean age and extent of disease, as assessed by staging, tumour size, myometrial invasion, and lymphovascular invasion were comparable between groups. Upstaging of the disease to stage 3 and 4 occurred in 11% of patients in the lymphadenectomy group. There were no significant differences in the medical or surgical complications between groups. At a median follow-up of 26 months, both groups had comparable survival (lymphadenectomy versus no lymphadenectomy: 34 versus 32 months). Similar survival was noted for patients who underwent the removal of more or less than 5 pelvic lymph nodes.</p></sec><sec id="st4"><title>Conclusion:</title><p>Selective lymphadenectomy offers the advantage of improved surgical staging but no therapeutic benefit in terms of overall survival.</p></sec></abstract><kwd-group><title>KEY WORDS</title><kwd>Endometrial cancer</kwd><kwd>Lymphadenectomy</kwd></kwd-group></article-meta></front></pmc><affiliations><list><country><li>Pakistan</li></country></list><tree><noCountry><name sortKey="Sheikh, Sana" sort="Sheikh, Sana" uniqKey="Sheikh S" first="Sana" last="Sheikh">Sana Sheikh</name></noCountry><country name="Pakistan"><noRegion><name sortKey="Chishti, Uzma" sort="Chishti, Uzma" uniqKey="Chishti U" first="Uzma" last="Chishti">Uzma Chishti</name></noRegion><name sortKey="Akhtar, Munazza" sort="Akhtar, Munazza" uniqKey="Akhtar M" first="Munazza" last="Akhtar">Munazza Akhtar</name><name sortKey="Aziz, Aliya B" sort="Aziz, Aliya B" uniqKey="Aziz A" first="Aliya B." last="Aziz">Aliya B. 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