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Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research

2038 - the impact of lymph node dissection on high risk versus low risk endometrial cancer

Date

20 Oct 2018

Session

Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research

Topics

Pathology/Molecular Biology

Tumour Site

Endometrial Cancer

Presenters

CHUYAO ZHANG

Citation

Annals of Oncology (2018) 29 (suppl_8): viii332-viii358. 10.1093/annonc/mdy285

Authors

C. ZHANG, A. Soochit, J.H. Liu

Author affiliations

  • Gynecologic Oncology, Sun Yat-sen University Cancer Center, 510060 - Guangzhou/CN
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Resources

Abstract 2038

Background

The aim of this study is to determine the benefits of lymph node dissection (LND) and the pattern of recurrence in low and high risk endometrial cancer (EC) patients.

Methods

EC patients who underwent surgery as primary treatment between April 2003 to March 2012 was identified and stratified into low-risk and high-risk groups for lymph node metastasis (LNM) according to these criteria: poor differentiation, non-endometrioid histology, deep myometrial invasion, cervical stromal involvement, adnexal involvement, tumor diameter ≥ 3cm, suspicious node in imaging. Univariate survival analysis followed by Cox-regression model for multivariate analysis was used to find prognostic factors for survival. The χ2 and Fisher’s exact test were used to compare categorical valuables.

Results

A total of 847 patients were included, among whom 524 received LND. After stratification 579 patients were assigned to high-risk group while 268 patients were assigned to low-risk group. LND was performed in 451 high-risk patients and in 73 low-risk patients with a rate of positive nodes of 14.1% (n = 64) and 2.7% (n = 2), respectively. Poor differentiation, non-endometrioid histology, deep myometrial invasion and adnexal involvement were independent prognostic factors. Whereas LNM was an independent prognostic factor for overall survival (OS, p = 0.03) but not for progression-free survival (PFS, p = 0.07). LND did not improve PFS (p = 0.56) or OS (p = 0.47) in the low-risk group and was not associated with OS (p = 0.17) in high-risk group. In 89 patients who had recurrence, 73 (13.9%) occurred in those with LND and 16 (5.0%) in those without LND. In high-risk group no significant difference was noted in recurrence rate (LND 16.0% vs without LND 8.6%, p = 0.06). Distant organs (lung, liver, bone, spleen and brain) and distant lymph nodes were the most common site of recurrence in both patients who underwent (5.9%, n = 31) LND and those who did not undergo (3.4%, n = 11) LND (p = 0.14).

Conclusions

According to our findings LND seemed not to have survival benefit for both high-risk and low-risk patients based on the above criteria, and it could not decrease risk of distance recurrence. A more reliable stratification model should be considered to determine the benefit of LND in EC.

Clinical trial identification

Legal entity responsible for the study

Sun Yet-sen University Cancer Center.

Funding

Has not received any funding.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

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