Endometrial Cancer and the Role of Lymphadenectomy.

IMPORTANCE

The role of lymph node dissection in early-stage endometrial cancer is highly debated, but staging and prognosis are dependent on knowledge of lymph node metastasis.

OBJECTIVE

We sought to review the available data on the use of lymph node assessment in presumed early-stage endometrial cancer.

EVIDENCE ACQUISITION: A comprehensive literature review was performed using MEDLINE, the Cochrane Collaborative Database, and PubMed.

RESULTS

There is limited retrospective data that suggest a therapeutic benefit to lymphadenectomy. Prospective randomized trials have not shown a benefit to lymphadenectomy in low-risk patients, but found significant morbidity in patients undergoing lymphadenectomy. Selective lymph node assessment should be used in low-risk endometrial cancer. Sentinel lymph node assessment is emerging as a potential strategy for lymph node assessment.

CONCLUSIONS AND RELEVANCE: Selective use of lymphadenectomy in early-stage endometrial cancer can reduce the morbidity associated with lymph node dissection without compromising clinical outcomes. Multiple strategies are available including sentinel lymph nodes and risk factor based lymphadenectomy.