The role of pelvic lymphadenectomy in endometrial cancer patients in minimizing the need for postoperative adjuvant

Authors

1 Obstetrics and Gynecology, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt

2 Obstetrics and Gynecology, Maadi Military Hospital-Armed forces, Cairo, Egypt

3 Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Abstract

Background: In developed countries, Endometrial cancer (EC) is the most frequent form of gynecologic cancer, comprising around six percent of all malignancies. Aim and objectives: To detect the pelvic lymphadenectomy function to avoid unnecessary adjuvant radiotherapy in patients with EC. Patients and methods: We performed this cohort research on 30 cases with a histologically proven diagnosis of EC. All cases had a total abdominal hysterectomy, bilateral salpingo-oophrectomy (TAH+BSO), peritoneal cytology, and pelvic lymphadenectomy at Maadi Military Hospital. Results: Among our studied population, 27.7% developed complications; 10% developed bleeding, followed by organ damage and infection in 6.7% for each, and DVT in 3.3%. No statistically significant variance was found in FIGO classification and tumor grade among patients with endometroid and non-endometroid carcinoma. Despite the fact that most of the included patients have endometrial thickness > 12 mm regardless of LN inclusion, a statistically significant rise was found in endometrial thickness in cases with positive LN compared with those with negative LN, with a P-value > 0.05. Conclusion: Our study did not find sufficient evidence to support the pelvic lymphadenectomy function for avoiding unnecessary postoperative adjuvant radiotherapy in cases with EC. Lymph node involvement was identified in a significant portion of cases, according to the studies, leading to some tumor classification upgrades. But no significant variance was found in FIGO classification, tumor grade, or endometrial thickness between endometroid and non-endometroid carcinoma patients.

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