Para‐aortic lymphadenectomy did not improve overall survival among women with type I endometrial cancer

Objective To compare outcomes and prognosis among women with type I endometrial cancer undergoing hysterectomy and bilateral salpingo‐oophorectomy (H‐BSO) with or without systematic pelvic lymphadenectomy (PLD) or para‐aortic lymphadenectomy (PALD). Methods Retrospective review of women postoperatively diagnosed with type I endometrial cancer who underwent H‐BSO at a university hospital in Chengdu, China (January 2010 to June 2012). Women were divided into no lymphadenectomy (PLD−/PALD−), systematic pelvic lymphadenectomy (PLD+/PALD−), or combined pelvic and para‐aortic lymphadenectomy (PLD+/PALD+) groups. Follow‐up was by telephone. Postoperative outcomes and prognosis were compared and risk factors were analyzed. Results In total, 333 women met the inclusion criteria: 121 underwent PLD+/PALD−, 166 underwent PLD+/PALD+, and 46 underwent PLD−/PALD−. There were no differences in pre‐operative characteristics among the groups (all P >0.05). The PLD+/PALD+ group had a higher laparotomy rate ( P =0.001), the PLD−/PALD− group had shorter operation time ( P =0.001) and lower blood loss ( P <0.001). There were no differences between the PLD+/PALD− and PLD+/PALD+ groups. Overall, 291 women had sufficient follow‐up data; there was no difference in overall survival, and PALD was not a predictor of survival. Conclusion Postoperative outcomes were similar among all surgical groups; a survival benefit of PALD was not demonstrated.