The survival impact of systematic lymphadenectomy in endometrial cancer with the use of propensity score matching analysis

Am J Obstet Gynecol. 2012 Jun;206(6):500.e1-11. doi: 10.1016/j.ajog.2012.03.027. Epub 2012 Mar 30.

Abstract

Objective: We sought to evaluate whether patients with endometrial cancer in the Surveillance, Epidemiology, and End Results database who underwent lymphadenectomy demonstrate improved survival.

Study design: The study population comprised 50,969 patients. The 3-year cause-specific survival was tested by using propensity score matching (PSM) analysis.

Results: The PSM analysis generated a balanced, matched cohort in which baseline characteristics were not significantly different. The benefit of systematic lymphadenectomy appears to be significant for presumed stage I International Federation of Gynecology and Obstetrics grade 3 cancers and presumed stages II-III cancer. The omission of lymphadenectomy in stage I did not appear to show a deleterious survival consequence if the differentiation grade was moderate (grade 2) or well (grade 1).

Conclusion: Using PSM analysis, our results show no evidence of benefit in terms of survival for systematic lymphadenectomy in women with stage I endometrial cancer, except for grade 3 cancers.

Publication types

  • Evaluation Study

MeSH terms

  • Adenocarcinoma / mortality
  • Adenocarcinoma / pathology
  • Adenocarcinoma / surgery*
  • Adult
  • Aged
  • Endometrial Neoplasms / mortality
  • Endometrial Neoplasms / pathology
  • Endometrial Neoplasms / surgery*
  • Female
  • Humans
  • Logistic Models
  • Lymph Node Excision*
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Grading
  • Neoplasm Staging
  • Pelvis
  • Propensity Score
  • Retrospective Studies
  • SEER Program
  • Survival Analysis
  • Treatment Outcome