Lymph Node Dissection Improved Overall Survival Among Patients With Stage 3 Endometrial Cancer
According to results from a univariable and multivariable analysis, undergoing lymph node dissection at the time of hysterectomy improved overall survival (OS) among patients with stage 3 endometrial cancer.
In this analysis, researchers identified 2882 patients from The National Cancer Database with clinical stage 3 endometrial cancer who underwent preoperative chemotherapy followed by hysterectomy with or without lymph node dissection. The primary end points included OS and prognostic factors of survival.
Among those who underwent lymph node dissection, 38% of patients had positive lymph nodes. The OS was 107 months in patients who underwent lymph node dissection and 84 months in patients who did not undergo lymph node dissection (hazard ratio [HR] 0.69; 95% confidence interval [CI] 0.57 to 0.84; P < .001). Factors found to be independently associated with improved survival included lymph node dissection (P < .001), adjuvant radiation (P < .001), histology (P < .001), tumor grade (P < .001), pathologic node status (P < .001), age (P < .001), type of insurance (P = .027), and race (P < .001).
Megan E. Lander, MD, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, et al, concluded this study “suggests that performing lymph node dissection at the time of hysterectomy is associated with improved overall survival in all patients with stage III endometrial cancer who receive upfront chemotherapy, regardless of age, race, insurance status, histologic subtype, tumor grade, pathologic node status, adjuvant radiation or chemotherapy.”
Source:
Lander ME, Vargo JA, Buckanovich R, et al. Lymph node dissection after neoadjuvant chemotherapy improves overall survival in clinical stage III endometrial cancer. Int J Gynecol Cancer. Published online: June 30, 2024. doi: 10.1136/ijgc-2024-005477
