Lymph Nodes and Uterine Cancer

Endometrial cancers that do not require surgical lymph node removal

(RxWiki News) Treating endometrial or uterine cancers typically involves a hysterectomy. Women who have aggressive disease may also undergo a lymphadenectomy to remove lymph nodes. 

Women who have uterine cancer that's considered low-risk - that is it's not likely to spread or recur - do not need to have surgery to remove nearby lymph nodes.

"Find out the probability of your cancer spreading and/or returning."

Researchers at the Mayo Clinic looked at the costs of lymphadenectomy, how it affects lifespan and development of other conditions (co-morbidity) in women with low-risk uterine cancer.

The team studied nearly 1,400 women who had had surgery to treat their endometrial cancer. Of this group, 385 cases met the Mayo Clinic criteria for being considered low-risk. A total of 80 women had lymphadenectomy (LND), and 385 did not have the surgery (non-LND).

After five years, 98.6 percent of all the women in the study were still alive. The 5-year survival from uterine cancer itself (cause-specific survival) was 97.3 percent for LND cases and 99 percent for non-LND cases.

The women who died were seven times more likely to succumb from co-morbidities than from endometrial cancer, the researchers discovered.

About twice as many women who had undergone LND experienced complications 30 days after the surgery as non-LND patients - 37.5 vs. 19.3 percent. Only one surgical patient had cancer spread to the lymph nodes.

Among the entire group, 11 women saw their cancer return, but there was not a single instance of recurrence in the lymph nodes.

The cost for patient care was significantly different, with the median 30-day cost for LND cases being $15,678 and $11,028 for non-LND cases.

The authors conclude that lymphadenectomy dramatically increases both costs and morbidity, without meaningful benefits over time. Therefore, the procedure isn't appropriate for women with low-risk uterine cancer.

Instead, hysterectomy alone should be the standard of care.

This study was published in May 20, 2012 supplement of the Journal of Clinical Oncology. Findings from the research were also presented at the 2012 annual meeting of the American Society of Clinical Oncology. 

None of the authors disclosed financial conflicts of interest.

Review Date: 
June 9, 2012