Lymphadenectomy and pelvic irradiation in high-risk endometrioid endometrial cancer: a population-based retrospective analysis using the SEER databank
The current role of lymphadenectomy in early-stage high-risk endometrioid endometrial cancer is to guide further adjuvant treatment according to lymph node status. Whether the procedure has any therapeutic role remains controversial. In this study we aimed to investigate the outcome of current pract...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
IMR Press
2021-02-01
|
| Series: | Clinical and Experimental Obstetrics & Gynecology |
| Subjects: | |
| Online Access: | https://www.imrpress.com/journal/CEOG/48/1/10.31083/j.ceog.2021.01.2168 |
| _version_ | 1828747977722691584 |
|---|---|
| author | AmrA Soliman Meike Schild-Suhren SayedA Mostafa Sarah Antar Ahmed Nezzal Basel Refky Onur Güralp Eduard Malik |
| author_facet | AmrA Soliman Meike Schild-Suhren SayedA Mostafa Sarah Antar Ahmed Nezzal Basel Refky Onur Güralp Eduard Malik |
| author_sort | AmrA Soliman |
| collection | DOAJ |
| description | The current role of lymphadenectomy in early-stage high-risk endometrioid endometrial cancer is to guide further adjuvant treatment according to lymph node status. Whether the procedure has any therapeutic role remains controversial. In this study we aimed to investigate the outcome of current practices by performing a population-based retrospective cohort analysis using the US population-derived freely accessible public Surveillance, Epidemiology and End Results program (SEER) database. SEER data from patients with endometrial cancer treated between 2004 and 2012 were accessed online on March 1, 2016. Kaplan-Meier estimators were used to describe the survival distribution and the log-rank (Mantel-Cox) test was used to perform overall and pairwise comparisons of the survival distributions. The cohort included 47,463 patients, 10,288 of whom fulfilled high-risk criteria. A higher lymph node yield count was associated with better overall survival, although the removal of more than 40 lymph nodes did not confer any further survival benefit. The application of pelvic irradiation without lymph node status confirmation did not provide a survival benefit. From this analysis, no evidence of a survival benefit associated with lymphadenectomy was found. However, the current role lymphadenectomy as a staging and guiding tool for further adjuvant treatment was supported. Well-designed prospective randomized trials are required to conclusively determine the prognostic and therapeutic value of lymphadenectomy in patients with high-risk endometrioid endometrial cancers. |
| first_indexed | 2024-04-14T04:52:58Z |
| format | Article |
| id | doaj.art-6b2674e6b3fa4afd9357e2cfc1118d7a |
| institution | Directory Open Access Journal |
| issn | 0390-6663 |
| language | English |
| last_indexed | 2024-04-14T04:52:58Z |
| publishDate | 2021-02-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Clinical and Experimental Obstetrics & Gynecology |
| spelling | doaj.art-6b2674e6b3fa4afd9357e2cfc1118d7a2022-12-22T02:11:14ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632021-02-0148115115910.31083/j.ceog.2021.01.2168S0390-6663(21)00060-9Lymphadenectomy and pelvic irradiation in high-risk endometrioid endometrial cancer: a population-based retrospective analysis using the SEER databankAmrA Soliman0Meike Schild-Suhren1SayedA Mostafa2Sarah Antar3Ahmed Nezzal4Basel Refky5Onur Güralp6Eduard Malik7University Women’s Hospital, Klinikum Oldenburg, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany. Rahel-Straus-Straße 10, 26133 Oldenburg, GermanyUniversity Women’s Hospital, Klinikum Oldenburg, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany. Rahel-Straus-Straße 10, 26133 Oldenburg, GermanyStatistics Department, Indiana University, Bloomington, 47405 IN, USAOncology Center Mansura University, Department of Surgical Oncology, University of Mansura, 35516 Mansura, EgyptOncology Center Mansura University, Department of Surgical Oncology, University of Mansura, 35516 Mansura, EgyptOncology Center Mansura University, Department of Surgical Oncology, University of Mansura, 35516 Mansura, EgyptUniversity Women’s Hospital, Klinikum Oldenburg, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany. Rahel-Straus-Straße 10, 26133 Oldenburg, GermanyUniversity Women’s Hospital, Klinikum Oldenburg, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany. Rahel-Straus-Straße 10, 26133 Oldenburg, GermanyThe current role of lymphadenectomy in early-stage high-risk endometrioid endometrial cancer is to guide further adjuvant treatment according to lymph node status. Whether the procedure has any therapeutic role remains controversial. In this study we aimed to investigate the outcome of current practices by performing a population-based retrospective cohort analysis using the US population-derived freely accessible public Surveillance, Epidemiology and End Results program (SEER) database. SEER data from patients with endometrial cancer treated between 2004 and 2012 were accessed online on March 1, 2016. Kaplan-Meier estimators were used to describe the survival distribution and the log-rank (Mantel-Cox) test was used to perform overall and pairwise comparisons of the survival distributions. The cohort included 47,463 patients, 10,288 of whom fulfilled high-risk criteria. A higher lymph node yield count was associated with better overall survival, although the removal of more than 40 lymph nodes did not confer any further survival benefit. The application of pelvic irradiation without lymph node status confirmation did not provide a survival benefit. From this analysis, no evidence of a survival benefit associated with lymphadenectomy was found. However, the current role lymphadenectomy as a staging and guiding tool for further adjuvant treatment was supported. Well-designed prospective randomized trials are required to conclusively determine the prognostic and therapeutic value of lymphadenectomy in patients with high-risk endometrioid endometrial cancers.https://www.imrpress.com/journal/CEOG/48/1/10.31083/j.ceog.2021.01.2168endometrial cancerlymphadenectomyhigh-risk endometrioid endometrial cancerpelvic irradiation |
| spellingShingle | AmrA Soliman Meike Schild-Suhren SayedA Mostafa Sarah Antar Ahmed Nezzal Basel Refky Onur Güralp Eduard Malik Lymphadenectomy and pelvic irradiation in high-risk endometrioid endometrial cancer: a population-based retrospective analysis using the SEER databank Clinical and Experimental Obstetrics & Gynecology endometrial cancer lymphadenectomy high-risk endometrioid endometrial cancer pelvic irradiation |
| title | Lymphadenectomy and pelvic irradiation in high-risk endometrioid endometrial cancer: a population-based retrospective analysis using the SEER databank |
| title_full | Lymphadenectomy and pelvic irradiation in high-risk endometrioid endometrial cancer: a population-based retrospective analysis using the SEER databank |
| title_fullStr | Lymphadenectomy and pelvic irradiation in high-risk endometrioid endometrial cancer: a population-based retrospective analysis using the SEER databank |
| title_full_unstemmed | Lymphadenectomy and pelvic irradiation in high-risk endometrioid endometrial cancer: a population-based retrospective analysis using the SEER databank |
| title_short | Lymphadenectomy and pelvic irradiation in high-risk endometrioid endometrial cancer: a population-based retrospective analysis using the SEER databank |
| title_sort | lymphadenectomy and pelvic irradiation in high risk endometrioid endometrial cancer a population based retrospective analysis using the seer databank |
| topic | endometrial cancer lymphadenectomy high-risk endometrioid endometrial cancer pelvic irradiation |
| url | https://www.imrpress.com/journal/CEOG/48/1/10.31083/j.ceog.2021.01.2168 |
| work_keys_str_mv | AT amrasoliman lymphadenectomyandpelvicirradiationinhighriskendometrioidendometrialcancerapopulationbasedretrospectiveanalysisusingtheseerdatabank AT meikeschildsuhren lymphadenectomyandpelvicirradiationinhighriskendometrioidendometrialcancerapopulationbasedretrospectiveanalysisusingtheseerdatabank AT sayedamostafa lymphadenectomyandpelvicirradiationinhighriskendometrioidendometrialcancerapopulationbasedretrospectiveanalysisusingtheseerdatabank AT sarahantar lymphadenectomyandpelvicirradiationinhighriskendometrioidendometrialcancerapopulationbasedretrospectiveanalysisusingtheseerdatabank AT ahmednezzal lymphadenectomyandpelvicirradiationinhighriskendometrioidendometrialcancerapopulationbasedretrospectiveanalysisusingtheseerdatabank AT baselrefky lymphadenectomyandpelvicirradiationinhighriskendometrioidendometrialcancerapopulationbasedretrospectiveanalysisusingtheseerdatabank AT onurguralp lymphadenectomyandpelvicirradiationinhighriskendometrioidendometrialcancerapopulationbasedretrospectiveanalysisusingtheseerdatabank AT eduardmalik lymphadenectomyandpelvicirradiationinhighriskendometrioidendometrialcancerapopulationbasedretrospectiveanalysisusingtheseerdatabank |