Azam Khalil Kheyal, Habib Maria, Hussain Sana, Usman Muhammad, Syed Aamir Ali
Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK.
Cureus. 2025 Apr 16;17(4):e82408. doi: 10.7759/cureus.82408. eCollection 2025 Apr.
Objective This study aimed to determine the role of pelvic lymphadenectomy by assessing nodal positivity on progression-free and overall survival in early-stage endometrial cancer. Materials and methods Eighty-nine women diagnosed with stage I/II endometrial cancer at presentation who underwent pelvic lymphadenectomy during surgery from 2019 to 2023 were included in this retrospective study. Data was collected using the Hospital Information System (HIS), and patient identifiers were anonymized. In addition to patient characteristics, final histopathology including cytology, type of surgery (laparoscopic vs. open), radiological evidence of lymphadenopathy before surgery, number of lymph nodes retrieved, histopathological evidence of nodal-positive/nodal-negative disease, adjuvant therapy (if any), recurrence-free survival, and overall survival were noted for these patients. Analysis was done using IBM SPSS Statistics for Windows, Version 25.0 (Released 2017; IBM Corp., Armonk, New York, United States), with means and frequencies noted for descriptive variables. Recurrence-free survival and overall survival were estimated in months for patients with lymph node-positive and lymph node-negative disease. Results Fifty-eight (65.2%) patients underwent laparoscopic surgery in this study cohort with radiological evidence of lymphadenopathy in 17 patients. Only six patients were found to have nodal-positive disease, out of which only three had lymphadenopathy on scans. Forty-six (51.7%) patients received adjuvant radiation therapy, while 16 (18%) underwent adjuvant chemotherapy. The estimated mean survival was 65.6 months, with the recurrence-free survival being 61.7 months. Among the patients with lymph node-positive disease, only one was found to have disease recurrence despite adjuvant treatment. Conclusion This study elucidates that patients who underwent pelvic lymphadenectomy and were subsequently found to have nodal disease went on to receive adequate adjuvant therapy; however, for some of them, there was no specific preoperative indicator to prompt the decision for pelvic lymphadenectomy. Therefore, until advanced techniques such as sentinel lymph node mapping are available in low-resource countries, surgical staging with pelvic nodal sampling is recommended.
目的 本研究旨在通过评估盆腔淋巴结清扫术对早期子宫内膜癌无进展生存期和总生存期的淋巴结阳性情况的作用。材料与方法 本回顾性研究纳入了2019年至2023年期间手术时接受盆腔淋巴结清扫术的89例初诊为I/II期子宫内膜癌的女性患者。使用医院信息系统（HIS）收集数据，并对患者标识符进行匿名化处理。除患者特征外，还记录了这些患者的最终组织病理学结果，包括细胞学、手术类型（腹腔镜手术与开放手术）、术前淋巴结病的影像学证据、切除的淋巴结数量、淋巴结阳性/阴性疾病的组织病理学证据、辅助治疗（如有）、无复发生存期和总生存期。使用IBM SPSS Statistics for Windows 25.0版（2017年发布；IBM公司，美国纽约州阿蒙克）进行分析，记录描述性变量的均值和频率。对淋巴结阳性和淋巴结阴性疾病患者的无复发生存期和总生存期以月为单位进行估计。结果 在本研究队列中，58例（65.2%）患者接受了腹腔镜手术，其中17例有淋巴结病的影像学证据。仅6例患者被发现有淋巴结阳性疾病，其中只有3例在扫描时有淋巴结病。46例（51.7%）患者接受了辅助放疗，而16例（18%）接受了辅助化疗。估计平均生存期为65.6个月，无复发生存期为61.7个月。在淋巴结阳性疾病患者中，尽管接受了辅助治疗，但仅1例被发现疾病复发。结论 本研究表明，接受盆腔淋巴结清扫术且随后被发现有淋巴结疾病的患者继续接受了充分的辅助治疗；然而，对于其中一些患者，没有特定的术前指标来促使决定进行盆腔淋巴结清扫术。因此，在资源匮乏的国家获得前哨淋巴结定位等先进技术之前，建议进行盆腔淋巴结采样的手术分期。
