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Annals of Surgical Oncology 8:723-728 (2001)
© 2001 Society of Surgical Oncology

ORIGINAL ARTICLES

Frequency and Determinants of Lymphadenectomy in Endometrial Carcinoma: A Population-Based Study From Northern Italy

Andrea Amadori, MD, Lauro Bucchi, MD, Gianfranco Gori, MD, Fabio Falcini, MD, Luca Saragoni, MD and Dino Amadori, MD

From the Departments of Obstetrics and Gynecology (AA, GG), Medical Oncology (FF, DA), and Pathology (LS) and the Romagna Cancer Registry (LB), Luigi Pierantoni Hospital, Forlì, Italy.

Correspondence: Address correspondence and reprint requests to: Lauro Bucchi, MD, Romagna Cancer Registry, Medical Oncology Department, Luigi Pierantoni Hospital, 47100 Forlì, Italy; Fax: 039-0543-731-736; E-mail: i.o.r{at}fo.nettuno.it

Background: The diffusion of pelvic and para-aortic lymphadenectomy for the surgical pathological staging of endometrial carcinoma into clinical practice has been evaluated only with questionnaire surveys of gynecological oncologists. No population-based information is available.

Methods: In this study of operable endometrial carcinoma cases registered by the population-based Romagna Cancer Registry (northern Italy) between 1987 and 1994, the association of demographic (age, time period, place of birth, place of residence, place of treatment, and marital status) and pathological factors (histological type, tumor grade, myoinvasion, and extension of disease to cervix, serosa, adnexa, and vagina) with the probability of lymphadenectomy was evaluated by multiple logistic regression analysis.

Results: Of the 300 potentially eligible cases, sufficient information was obtained for 276 (92%; median age, 63 years; range, 33–87 years). No case of para-aortic lymphadenectomy was observed. Pelvic lymphadenectomy was performed in 86 (31%) cases. The probability of pelvic lymphadenectomy was related to tumor grade (positive association), place of treatment, and marital status. All other variables, including myoinvasion and extension of disease to the cervix and beyond the uterus, had no effect whatsoever.

Conclusions: The most likely interpretations of results include poor acceptance of current surgical pathological staging criteria and insufficient use of standard diagnostic techniques for preoperative and intraoperative assessment of myoinvasion and extrauterine spread.

Key Words: Endometrial carcinoma • Staging • Lymphadenectomy • Tumor grade • Myoinvasion






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Copyright © 2001 by the Society of Surgical Oncology.