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[Effect of pelvic lymphadenectomy on prognosis of endometrial carcinoma].

OBJECTIVE
To study the associated factors with pelvic lymph node metastasis of endometrial carcinoma and the effect of pelvic lymphadenectomy on prognosis of the disease.


METHODS
Totally 102 patients with endometrial carcinoma who underwent pelvic lymphadenectomy (90 patients) or lymph node biopsy (12 patients) in our hospital from Jan 1981 to Dec 2002 were recruited. The relationship between various clinicopathologic factors and pelvic lymph node metastasis was analyzed. Prognosis of ninety patients with pelvic lymphadenectomy was compared with 90 patients without pelvic lymphadenectomy (control group) in the same period. The 5-year survival was calculated by life table method.


RESULTS
The incidence of pelvic lymph node metastasis increased in patients with low grade (46%), deep myometrium invasion (42%), cervical involvement (44%), positive peritoneal cytology (52%), adenexal metastasis (75%) and distant spread (100%). The 5-year survival was lower in patients with lymph node metastasis (37%) than that without lymph node metastasis (89%, P < 0.05). Univariate and COX regression analysis demonstrated that pelvic lymphadenectomy did not improve patients' prognosis. The 5-year survival in patients undergoing lymphadenectomy was 78%, and it was 72% in patients without lymphadenectomy.


CONCLUSIONS
The high risk factors for pelvic lymph node metastasis in endometrial carcinoma include low grade differentiation deep myometrium invasion, cervical involvement, positive peritoneal cytology, adenexal metastasis and distant spread. The prognosis is poorer in patients with pelvic lymph node metastasis. Pelvic lymphadenectomy could not improve the prognosis of patients with endometrial carcinoma.