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Resection of lymph node metastases influences survival in stage IIIC endometrial cancer.

Publication ,  Journal Article
Havrilesky, LJ; Cragun, JM; Calingaert, B; Synan, I; Secord, AA; Soper, JT; Clarke-Pearson, DL; Berchuck, A
Published in: Gynecol Oncol
December 2005

OBJECTIVE: Surgical staging of endometrial cancer identifies those patients with microscopic metastatic disease most likely to benefit from adjuvant therapy and may also confer therapeutic benefit. Our objective was to compare survival of patients who underwent resection of grossly positive lymph nodes (LN) to those with microscopically positive LN. METHODS: Patients had stage IIIC endometrial cancer with pelvic and/or aortic LN metastases and underwent surgery between 1973 and 2002. Exclusion criteria included pre-surgical radiation and second primary cancer. Survival was analyzed using Kaplan-Meier method and Cox proportional hazards model. RESULTS: Mean age of 96 patients with stage IIIC endometrial cancer was 64. There were 45 cases with microscopic LN involvement and 51 with grossly enlarged LN. Overall, 41% had disease in aortic LN, which in 18% represented isolated aortic LN metastasis. Adjuvant therapies were given to 92% of patients (85% radiotherapy, 10% chemotherapy, 10% progestins). Among those with grossly involved LN, 86% were completely resected. Five-year disease-specific survival (DSS) was 63% in 45 patients with microscopic metastatic disease compared to 50% in 44 patients with grossly positive LN completely resected and 43% in 7 with residual macroscopic disease. In multivariable analyses, gross nodal disease not debulked (HR=6.85, P=0.009), serosal/adnexal involvement (HR=2.24, P=0.036), diagnosis prior to 1989 (HR=4.33, P<0.001), older age (HR=1.09, P<0.001), and >2 positive lymph nodes (HR=3.12, P=0.007) were associated with lower DSS. CONCLUSION: Grossly involved LN can often be completely resected in patients with stage IIIC endometrial cancer. These retrospective data provide evidence suggestive of a therapeutic benefit for lymphadenectomy in endometrial cancer.

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Published In

Gynecol Oncol

DOI

ISSN

0090-8258

Publication Date

December 2005

Volume

99

Issue

3

Start / End Page

689 / 695

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Survival Rate
  • Radiotherapy, Adjuvant
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Middle Aged
  • Lymph Nodes
  • Lymph Node Excision
  • Hysterectomy
  • Humans
 

Citation

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Chicago
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Havrilesky, L. J., Cragun, J. M., Calingaert, B., Synan, I., Secord, A. A., Soper, J. T., … Berchuck, A. (2005). Resection of lymph node metastases influences survival in stage IIIC endometrial cancer. Gynecol Oncol, 99(3), 689–695. https://doi.org/10.1016/j.ygyno.2005.07.014
Havrilesky, Laura J., Janiel M. Cragun, Brian Calingaert, Ingrid Synan, Angeles Alvarez Secord, John T. Soper, Daniel L. Clarke-Pearson, and Andrew Berchuck. “Resection of lymph node metastases influences survival in stage IIIC endometrial cancer.Gynecol Oncol 99, no. 3 (December 2005): 689–95. https://doi.org/10.1016/j.ygyno.2005.07.014.
Havrilesky LJ, Cragun JM, Calingaert B, Synan I, Secord AA, Soper JT, et al. Resection of lymph node metastases influences survival in stage IIIC endometrial cancer. Gynecol Oncol. 2005 Dec;99(3):689–95.
Havrilesky, Laura J., et al. “Resection of lymph node metastases influences survival in stage IIIC endometrial cancer.Gynecol Oncol, vol. 99, no. 3, Dec. 2005, pp. 689–95. Pubmed, doi:10.1016/j.ygyno.2005.07.014.
Havrilesky LJ, Cragun JM, Calingaert B, Synan I, Secord AA, Soper JT, Clarke-Pearson DL, Berchuck A. Resection of lymph node metastases influences survival in stage IIIC endometrial cancer. Gynecol Oncol. 2005 Dec;99(3):689–695.
Journal cover image

Published In

Gynecol Oncol

DOI

ISSN

0090-8258

Publication Date

December 2005

Volume

99

Issue

3

Start / End Page

689 / 695

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Survival Rate
  • Radiotherapy, Adjuvant
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Middle Aged
  • Lymph Nodes
  • Lymph Node Excision
  • Hysterectomy
  • Humans