Extensive Lymph Node Removal Improves Survival in Endometrial Cancer Patients
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.
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.