Huang C.-Y.Ho C.-M.YU-LI CHENYou S.-L.CHI-AN CHENWEN-FANG CHENG2020-02-142020-02-1420130748-79832-s2.0-84875222324https://scholars.lib.ntu.edu.tw/handle/123456789/458597Aims: To investigate the role of lymphadenectomy in uterine endometrioid carcinoma based on the 2009 FIGO staging system. Methods: Using an institution-maintained cancer registry database, all patients who were treated surgically for endometrial cancer from 1991 to 2008 in two medical centers were analyzed. Kaplan-Meier and Cox proportional hazards methods were used to determine the role of lymphadenectomy. Results: From 961 women with uterine endometrioid carcinoma, 680 underwent lymphadenectomy and 281 did not. Young age, early-stage disease, low-grade tumor, and lymphadenectomy were favorable independent prognostic factors. The five-year disease-specific survival (DSS) of stages IA, IB, II, and III, and the two-year DSS of stage IV patients who underwent lymphadenectomy were 97.8%, 88.3%, 91.5%, 70.5%, and 32.1%, respectively, compared to 98.7%, 70.0%, 73.3%, 42.9%, and 16.6% in those without lymphadenectomy (p > 0.05 for stage IA; p < 0.01 for stages IB-IV, log-rank test). In high-risk patients (i.e., poorly-differentiated, outer-half myometrial invasion, and stages II-IV), more extensive lymph node resection was associated with an improved five-year DSS, from 71.3% (1-10 nodes removed) and 85.3% (11-20 nodes removed) to 86.8% (>20 nodes removed) (p = 0.02, log-rank test). For stage IIIC-IV patients with nodal metastasis, the extent of node resection also significantly improved the five-year DSS, from 34.4% (1-10 nodes removed) and 62.4% (11-20 nodes removed) to 79.6% (>20 nodes removed) (p = 0.04, log-rank test). Conclusions: Lymphadenectomy improves the survival of patients with uterine endometrioid carcinoma stage IB to stage IV. The extent of lymphadenectomy also improves the survival of high-risk patients and those with nodal disease. ? 2013 Elsevier Ltd. All rights reserved.[SDGs]SDG3antineoplastic agent; adult; age distribution; aged; article; cancer adjuvant therapy; cancer chemotherapy; cancer grading; cancer invasion; cancer prognosis; cancer radiotherapy; cancer recurrence; cancer staging; controlled study; disease specific survival; endometrioid carcinoma; female; figo staging; high risk patient; human; human tissue; lymph node dissection; lymph node metastasis; major clinical study; paraaortic lymph node; pelvis lymphadenectomy; priority journal; risk factor; therapy effect; Adult; Aged; Aged, 80 and over; Carcinoma, Endometrioid; Disease-Free Survival; Endometrial Neoplasms; Female; Humans; Lymph Node Excision; Lymphatic Metastasis; Middle Aged; Multivariate Analysis; Proportional Hazards Models; Retrospective Studies; Survival Rate; Taiwanjournal article10.1016/j.ejso.2013.01.00256601533000