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Article Dans Une Revue International Journal of Gynecological Cancer Année : 2019

Does lymphadenectomy improve survival in patients with intermediate risk endometrial cancer? a multicentric study from the francogyn research group

Lilia Bougherara
  • Fonction : Auteur
Henri Azais
  • Fonction : Auteur
Geoffroy Canlorbe
Marcos Ballester
  • Fonction : Auteur
  • PersonId : 1077600
  • IdRef : 092189806
Sofiane Bendifallah
  • Fonction : Auteur
Charles Coutant
  • Fonction : Auteur
Vincent Lavoue
  • Fonction : Auteur
Lobna Ouldamer
  • Fonction : Auteur
Olivier Graesslin
  • Fonction : Auteur
Cyril Touboul
Juan Pablo Estevez
  • Fonction : Auteur

Résumé

The role of lymphadenectomy in intermediate risk endometrial cancer remains uncertain. We evaluated the impact of lymphadenectomy on overall survival and relapse-free survival for patients with intermediate risk endometrial cancer. We retrospectively reviewed patients from the FRANCOGYN database with intermediate risk endometrial cancer, based on pre-operative and post-operative criteria (type 1, grade 1-2 tumors with deep (> 50%) myometrial invasion and no lymphovascular space invasion), who received primary surgical treatment between November 2002 and August 2013. We compared overall survival and relapse-free survival between staged and unstaged patients. From 1235 screened patients, we selected 108 patients with intermediate risk endometrial cancer. Eighty-two (75.9%) patients underwent nodal staging (consisting of pelvic +/- para-aortic lymphadenectomy). Among them, 35 (32.4%) had lymph node disease. The median follow-up was 25 months (range 0.4 to 155.0). The overall survival rates were 82.5% for patients staged (CI 64.2 to 91.9) vs 77.9 % for unstaged patients (CI 35.4 to 94.2) (P = 0.73). The relapse-free survival rates were 68.9% for staged patients (CI 51.2 to 81.3) vs 68.8% for unstaged patients (CI 29.1 to 89.3) (P=0.67). Systematic nodal staging does not appear to improve overall survival and relapse-free survival for patients with IR EC but could provide information to tailor adjuvant therapy. Sentinel lymph node dissection may be an effective and less invasive alternative staging technique and should provide a future alternative for this population.
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Dates et versions

hal-04548465 , version 1 (16-04-2024)

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Lilia Bougherara, Henri Azais, Helene Behal, Geoffroy Canlorbe, Marcos Ballester, et al.. Does lymphadenectomy improve survival in patients with intermediate risk endometrial cancer? a multicentric study from the francogyn research group. International Journal of Gynecological Cancer, 2019, International Journal of Gynecological Cancer, 29 (2), pp.282-289. ⟨10.1136/ijgc-2018-000051⟩. ⟨hal-04548465⟩
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