Pei Kaige, Li Dongmei, Xi Mingrong
Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University, No. 20, Section 3, Renmin South Road, Wuhou District, Chengdu, 610041, Sichuan, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China.
Sci Rep. 2025 May 7;15(1):15952. doi: 10.1038/s41598-025-00531-3.
For patients with low-grade endometrioid carcinoma of stage T1a, the role of lymphadenectomy in staging surgery remains controversial. This study aims to evaluate the impact of lymphadenectomy on cancer-specific survival (CSS) in this patient population using a large, population-based dataset. We conducted a retrospective analysis using the Surveillance, Epidemiology, and End Results (SEER) database, identifying 11,014 patients with stage T1a, low-grade endometrioid carcinoma from 2004 to 2015. Patients were divided into lymphadenectomy and non-lymphadenectomy groups. Propensity score matching (PSM) was performed to balance baseline characteristics. Kaplan-Meier analysis, log-rank tests, and multivariate Cox regression were used to assess CSS and identify independent prognostic factors. Before PSM, the non-lymphadenectomy group had higher CSS compared to the lymphadenectomy group (HR = 1.56, 95% CI: 1.16-2.10, p = .003). After 1:1 PSM, CSS was similar between the two groups (HR = 1.09, 95% CI: 0.78-1.53, p = .605). Subgroup analyses showed no significant differences in CSS except for the subgroup with tumor size > 2 cm, where non-lymphadenectomy was associated with better CSS (HR = 0.50, p = .035). Multivariate Cox regression analysis identified age, marital status, histological grade, and chemotherapy as independent prognostic factors for CSS, while lymphadenectomy was not (p = .980).. Our findings suggest that lymphadenectomy does not improve CSS in patients with low-grade endometrioid carcinoma of stage T1a.
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