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Surgical staging for endometrial cancer in the elderly - is there a role for lymphadenectomy?

Publication ,  Journal Article
Lowery, WJ; Gehrig, PA; Ko, E; Secord, AA; Chino, J; Havrilesky, LJ
Published in: Gynecol Oncol
July 2012

OBJECTIVES: We sought to evaluate the effect of systematic lymphadenectomy (LND) on endometrial cancer-specific survival in an elderly population. METHODS: Data were obtained from the Surveillance, Epidemiology, and End Results (SEER) program from 1988 to 2006. Women who underwent primary hysterectomy for non-serous, non-clear cell endometrial carcinoma were included. Women were stratified by age (<70, 70-79, and ≥ 80) and disease-specific survival (DSS) was analyzed via the Kaplan-Meier method and stratified by postoperative grade. Cohorts were compared using the log-rank test. In a simulated population, the disease-specific survival of women with pre-operative grade 1 endometrial carcinoma was calculated using a weighted average survival accounting for those upgraded at final pathology. RESULTS: Endometrial cancer was identified in 5759 women ≥ 80 years old. Disease specific survival at 5 years for the LND and no LND groups was 93.4% and 94.5% (p=0.36) for grade 1, 84.4% and 85% (p=0.97) for grade 2, and 65.9% and 60.9% (p=0.002) for grade 3. In the simulated pre-operative grade 1 group, 5 year disease-specific survival (DSS) was 91% in the LND group and 92% in the no LND group. CONCLUSION: In women older than 80, systematic lymphadenectomy is associated with improved DSS for high grade, but similar DSS for low grade endometrial cancer, consistent with what is seen with younger women. As there is no clear survival benefit to lymphadenectomy in elderly women presenting with low grade disease, the surgeon should carefully weigh the surgical risks and benefits in this patient population, which may be at higher risk for morbidity.

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Published In

Gynecol Oncol

DOI

EISSN

1095-6859

Publication Date

July 2012

Volume

126

Issue

1

Start / End Page

12 / 15

Location

United States

Related Subject Headings

  • United States
  • Survival Rate
  • SEER Program
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Neoplasm Grading
  • Lymph Node Excision
  • Hysterectomy
  • Humans
  • Female
 

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Lowery, W. J., Gehrig, P. A., Ko, E., Secord, A. A., Chino, J., & Havrilesky, L. J. (2012). Surgical staging for endometrial cancer in the elderly - is there a role for lymphadenectomy? Gynecol Oncol, 126(1), 12–15. https://doi.org/10.1016/j.ygyno.2012.05.003
Lowery, William J., Paola A. Gehrig, Emily Ko, Angeles Alvarez Secord, Junzo Chino, and Laura J. Havrilesky. “Surgical staging for endometrial cancer in the elderly - is there a role for lymphadenectomy?Gynecol Oncol 126, no. 1 (July 2012): 12–15. https://doi.org/10.1016/j.ygyno.2012.05.003.
Lowery WJ, Gehrig PA, Ko E, Secord AA, Chino J, Havrilesky LJ. Surgical staging for endometrial cancer in the elderly - is there a role for lymphadenectomy? Gynecol Oncol. 2012 Jul;126(1):12–5.
Lowery, William J., et al. “Surgical staging for endometrial cancer in the elderly - is there a role for lymphadenectomy?Gynecol Oncol, vol. 126, no. 1, July 2012, pp. 12–15. Pubmed, doi:10.1016/j.ygyno.2012.05.003.
Lowery WJ, Gehrig PA, Ko E, Secord AA, Chino J, Havrilesky LJ. Surgical staging for endometrial cancer in the elderly - is there a role for lymphadenectomy? Gynecol Oncol. 2012 Jul;126(1):12–15.
Journal cover image

Published In

Gynecol Oncol

DOI

EISSN

1095-6859

Publication Date

July 2012

Volume

126

Issue

1

Start / End Page

12 / 15

Location

United States

Related Subject Headings

  • United States
  • Survival Rate
  • SEER Program
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Neoplasm Grading
  • Lymph Node Excision
  • Hysterectomy
  • Humans
  • Female