The role of lymph node dissection in the surgical treatment of endometrial cancer patients (retrospective analysis)

Abstract

Purpose: Endometrial cancer in recent years has taken the lead among cancer processes of the female reproductive system. The feasibility of pelvic and para-aortic lymph node dissection in patients with endometrial cancer has always been a controversial issue. The aim of the presented paper is to evaluate the feasibility of pelvic and para-aortic lymph node dissection in patients with endometrial cancer, depending on the stage of the disease, postoperative complications, and patient survival, depending on the volume of surgical intervention.

Methods: The study involved 285 patients with stages of I-IV endometrioid endometrial cancer of the Pre-graduate Department of Oncogynecology of the National Cancer Institute. The average age of patients was 55 ± 5.7 years. In 74.5%, the disease was detected at stage I and uterine extirpation was performed with/without appendages.

Results: The duration of the operation varies depending on the volume of intervention-from 1 h 30 min ± 10 min for panhysterectomy, up to 3 h 20 min ± 10 min when performing para-aortic lymph node dissection. The average number of lymph nodes removed was-7 ± 1.1 pelvic and 12 ± 1.5 para-aortic.

Conclusion: The basic principles of surgical treatment consist in individual choice of the scope of surgical intervention, performing adequate lymph node dissection, and preventing relapse and metastasis of the disease.

Keywords: Endometrial cancer; Laparoscopy; Laparotomy; Pelvic lymph node dissection; Surgery.

Fig. 1

Metastasis to para-aortic lymph nodes. 1—Right ureter; 2—aorta with bifurcation to the common iliac arteries; 3—inferior vena cava; 4—clamp; 5—lymph node is metastasised; 6—descending colon loop

Fig. 2

Condition after pelvic and para-aortic lymph node sections. 1—Ureter; 2—aorta from the level of the renal arteries to the level of bifurcation; 3—inferior vena cava; 4—descending colon loop; 5—promontorium; 6—duodenum; 7—superior mesenteric artery; 8—inferior mesenteric artery