Impact of lymphadenectomy on the treatment of endometrial cancer using data from the JSOG cancer registry
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초록
ObjectiveRegional lymph node (LN) dissection is a standard surgical procedure for endometrial cancer, but there is currently noclear consensus on its therapeutic significance. We aimed to determine the impact of regional LN dissection on theoutcome of endometrial cancer. MethodsStudy subjects comprised 36,813 patients who were registered in the gynecological tumor registry of the JapanSociety of Obstetrics and Gynecology, had undergone initial surgery for endometrial cancer between 2004 and2011, and whose clinicopathological factors and prognosis were appropriate for our investigation. The followingclinicopathological factors were obtained from the registry: age, surgical stage classification, Union for InternationalCancer Control tumor, node, metastasis classification, histological type, histological differentiation, presence orabsence of LN dissection, and postoperative treatment. We retrospectively analyzed the clinicopathological factorsand therapeutic outcomes for patients with endometrial cancer. ResultsAnalysis of all subjects showed that the group that underwent LN dissection had a significantly better overall survivalthan the group that did not undergo dissection. Analysis based on stage showed similar results across groups, exceptfor stage Ia. Analysis based on stage and histological type showed similar results across groups, except for stageIa endometrial carcinoma G1 or Ia G2. Multivariate analysis of prognostic factors indicated that LN dissection is anindependent prognostic factor and that it has a greater impact on prognosis than adjuvant chemotherapy. ConclusionDespite the limitations of a retrospective study with some biases, the results suggest that LN dissection in endometrialcancer has a prognostic effect.
Abstract
ObjectiveRegional lymph node (LN) dissection is a standard surgical procedure for endometrial cancer, but there is currently noclear consensus on its therapeutic significance. We aimed to determine the impact of regional LN dissection on theoutcome of endometrial cancer. MethodsStudy subjects comprised 36,813 patients who were registered in the gynecological tumor registry of the JapanSociety of Obstetrics and Gynecology, had undergone initial surgery for endometrial cancer between 2004 and2011, and whose clinicopathological factors and prognosis were appropriate for our investigation. The followingclinicopathological factors were obtained from the registry: age, surgical stage classification, Union for InternationalCancer Control tumor, node, metastasis classification, histological type, histological differentiation, presence orabsence of LN dissection, and postoperative treatment. We retrospectively analyzed the clinicopathological factorsand therapeutic outcomes for patients with endometrial cancer. ResultsAnalysis of all subjects showed that the group that underwent LN dissection had a significantly better overall survivalthan the group that did not undergo dissection. Analysis based on stage showed similar results across groups, exceptfor stage Ia. Analysis based on stage and histological type showed similar results across groups, except for stageIa endometrial carcinoma G1 or Ia G2. Multivariate analysis of prognostic factors indicated that LN dissection is anindependent prognostic factor and that it has a greater impact on prognosis than adjuvant chemotherapy. ConclusionDespite the limitations of a retrospective study with some biases, the results suggest that LN dissection in endometrialcancer has a prognostic effect.
참고문헌 (13)
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