Original Investigation

Prognostic effect of isolated paraaortic nodal spread in endometrial cancer

10.4274/jtgga.2017.0152

  • Osman Türkmen
  • Derman Başaran
  • Alper Karalok
  • Günsu Cömert Kimyon
  • Tolga Taşçı
  • Işın Üreyen
  • Gökhan Tulunay
  • Taner Turan

J Turk Ger Gynecol Assoc 0;0(0):0-0 [e-Pub] PMID: 29588264

Objective:

To evaluate the prognostic effect of isolated paraaortic lymph node metastasis in endometrial cancer (EC).

Materials and Methods:

This retrospective study included patients with FIGO 2009 stage IIIC2 disease due to isolated paraaortic lymph node metastasis (LNM). Patients with sarcomatous histology, synchronous gynecologic cancers and patients with concurrent pelvic lymph node metastases or patients that have intraabdominal tumor spread were excluded. Kaplan-Meier method was used for calculation of progression free survival (PFS) and overall survival.

Results:

1614 patients were operated for EC during study period.961 patients underwent lymph node dissection and 25 (2.6%) were found to have isolated LNM in paraaortic region and these constituted the study cohort.20 (80%) patients had endometrioid EC. Median number of retrieved lymph nodes from pelvic region and paraaortic region was 21.5 (range; 5-41) and 34.5 (range; 1-65), respectively. Median number of metastatic paraaortic nodes was 1 (range; 1-32).The median follow-up time was 15 months (range 5-94). 7 (28%) patients recurred after a median of 20 months (range, 3-99) from initial surgery. 3 patients recurred only in pelvis, one patient had upper abdominal spread and 3 had isolated extraabdominal recurrence.İnvolvement of uterine serosa, positive peritoneal cytology and presence of adnexal metastasis were significantly associated with diminished PFS (p<0.05).

Conclusions:

The presence of serosal involvement or adnexal involvement is as important as gross peritoneal spread and is related with poor survival in patients with isolated paraaortic nodal spread in EC. Chemotherapy should be the mainstay of treatment in this patient cohort which may eradicate systemic tumor spread.

Keywords: endometrial cancer,paraaortic lymph node metastasis,serosal involvement