According to the results of a study published in the journal Cancer, removal of a larger number of lymph nodes improves survival among women with intermediate or high-risk endometrial cancer (Stage IB, Grade 3; Stage IC-IV, all grades).
Endometrial cancer is a cancer of the uterus and is the most frequently diagnosed gynecologic cancer in the U.S. Fortunately, long-term survival rates are high for cancers detected and treated early.
Standard treatment for endometrial cancer includes a total abdominal hysterectomy (removal of the uterus) and bilateral salpingo-oophorectomy (removal of the fallopian tubes and ovaries). The surgical procedure in which the lymph nodes are removed and examined to see if they contain cancer is called a lymphadenectomy.
Removal of a larger of number of lymph nodes during a lymphadenectomy could influence survival if it results in more accurate staging of the cancer. In addition, it’s possible that removal of a larger number of nodes may be more likely to completely remove cancer, including extremely small areas of cancer that are not detected by pathologic review.
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To explore the relationship between survival and the number of lymph nodes removed, researchers conducted a study among 12,333 endometrial cancer patients who had at least one lymph node removed.
- Among women with low-risk endometrial cancer (Stage IA, all grades; Stage IB, Grades 1 and 2), there was no relationship between the number of lymph nodes removed and survival.
- Among women with intermediate- or high-risk endometrial cancer (Stage IB, Grade 3; Stage IC-IV, all grades), women with a larger number of lymph nodes removed had better survival. Five-year survival increased from 75% among women with a single node removed to 87% among women with more than 20 nodes removed.
- In the group of women with Stage IIIC or IV node-positive cancer, five-year survival increased from 51% among women with only a single node removed to 72% among women with more than 20 nodes removed.
The researchers conclude that the number of lymph nodes removed influences survival among women with intermediate- or high-risk endometrial cancer. Survival was better among women with a larger number of nodes removed.
Reference: Chan JK, Cheung MK, Huh WK et al. Therapeutic Role of Lymph Node Resection in Endometrioid Corpus Cancer. Cancer. Early online publication September 14, 2006.