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

Am J Obstet Gynecol

Department of Obstetrics and Gynecology, Hospital Tenon, APHP (Assistance Publique des Hôpitaux de Paris), Paris, France.

Published: June 2012

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.

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http://dx.doi.org/10.1016/j.ajog.2012.03.027DOI Listing

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