The incidence of isolated paraaortic nodal metastasis in surgically staged endometrial cancer patients with negative pelvic lymph nodes Journal Article

  

Authors:	Abu-Rustum, N. R.; Gomez, J. D.; Alektiar, K. M.; Soslow, R. A.; Hensley, M. L.; Leitao, M. M. Jr; Gardner, G. J.; Sonoda, Y.; Chi, D. S.; Barakat, R. R.
Article Title:	The incidence of isolated paraaortic nodal metastasis in surgically staged endometrial cancer patients with negative pelvic lymph nodes
Abstract:	Objective: To describe the incidence of isolated paraaortic nodal metastasis in surgically staged endometrial cancer patients with negative pelvic lymph nodes. Methods: Using a prospectively maintained database we identified all cases of endometrial cancer that had both pelvic and aortic nodal dissection and determined the rate of isolated paraaortic nodal metastasis in the setting of negative pelvic nodes. For this report a satisfactory pelvic node dissection meant the identification of 8 or more pelvic nodes on final pathology. Results: 1942 endometrial cancer patients were surgically treated at our institution from 1/93 to 1/08. 847 had both pelvic and paraaortic nodes removed during surgery and identified by pathology. 734 had negative pelvic nodes with at least one paraaortic node identified. Only 12 (1.6%) had positive paraaortic nodes with negative pelvic nodes. Seven (1%) of 640 cases with 8 or more negative pelvic nodes had positive paraaortic nodes. Final grade for these cases included: G1 (2), G2 (2), G3 (1), papillary serous (1), and undifferentiated (1). Of the 570 cases with a final diagnosis of grade 1 endometrial cancer, 187 had both pelvic and aortic node dissection during the same operation, and 2/187 (1%) had a positive paraaortic node with negative pelvic nodes. Conclusions: Isolated paraaortic nodal metastasis in the setting of negative pelvic nodes occurs in ∼ 1% of surgically staged endometrial cancer cases. This low rate seems consistent for low- and high-grade lesions. Future studies looking at the incidence of isolated paraaortic nodal metastasis in the setting of negative sentinel pelvic nodes are warranted. © 2009 Elsevier Inc. All rights reserved.
Keywords:	adult; cancer chemotherapy; aged; aged, 80 and over; middle aged; young adult; major clinical study; histopathology; cancer patient; cancer radiotherapy; postoperative care; cancer staging; endometrial cancer; lymph node metastasis; paraaortic nodes; sentinel node; staging; antineoplastic agent; cancer diagnosis; cancer incidence; endometrioid carcinoma; endometrium carcinoma; hysterectomy; lymph node dissection; paraaortic lymph node; pelvis lymph node; undifferentiated carcinoma; endometrial neoplasms; lymph nodes; lymphatic metastasis; neoplasm staging; pelvis
Journal Title:	Gynecologic Oncology
Volume:	115
Issue:	2
ISSN:	0090-8258
Publisher:	Elsevier Inc.
Date Published:	2009-11-01
Start Page:	236
End Page:	238
Language:	English
DOI:	10.1016/j.ygyno.2009.07.016
PUBMED:	19666190
PROVIDER:	scopus
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-70349745230&partnerID=40&md5=984e0141b5210928caf7d4ac1c14e6dc
Notes:	--- - "Cited By (since 1996): 2" - "Export Date: 30 November 2010" - "CODEN: GYNOA" - "Source: Scopus"

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