Lymphadenectomy and prognosis for elderly females with stage I endometrioid endometrial cancer
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The potential therapeutic benefits of lymphadenectomy in endometrial cancer (EC) patients are still ambiguous. Therefore, a population-based retrospective analysis was conducted to determine the association between lymphadenectomy and survival in elderly female patients with stage I endometrioid EC.
The Surveillance, Epidemiology, and End Results (SEER) program database was retrospectively analyzed, and data of 63,372 female patients with early-stage type I EC from 1988 to 2013 were collected. The main patient and tumor characteristics included marital status, age, ethnicity, time of diagnosis, tumor grade, radiotherapy, and lymphadenectomy status. Kaplan–Meier and Cox proportional hazard regression analyses were performed to determine the association between lymph node dissection and the overall survival (OS) and cancer-specific survival in women older than 50 years with stage I endometrioid EC.
The majority (83.7%) of the patients who met the inclusion criteria for the study were older than 50 years. In both grade 1 and 2 patients aged over 50 years, lymph node conservation was associated with a higher mortality risk compared to lymphadenectomy (all P < 0.005). Multivariate analysis indicated that lymphadenectomy was an independent predictor of improved OS in early-stage type 1 EC patients, with hazard ratios of 0.893 and 0.827 for the grade 1 and grade 2 patients, respectively (P < 0.0001).
Lymphadenectomy could improve long-term OS in women older than 50 years with grade 1 and 2 endometrioid EC.
KeywordsLymphadenectomy Prognosis Elderly Endometrioid endometrial cancer
International Classification of Diseases for Oncology, 3rd ed
Lymph node dissection
Surveillance, Epidemiology, and End Results
LZ: conceptualization, project administration, manuscript writing. LL: data curation, investigation, methodology. YY: data curation, formal analysis, software. XH: formal analysis, methodology, software. XF: resources, validation. YY: project administration, validation. JL: conceptualization, supervision, manuscript reviewing and editing.
There was no funding obtained for this study.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest.
As the study consisted of the retrospective analysis of anonymized data according to the local ethics committee, a special approval is generally not required.
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