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Chapter-20 Role of Lymphadenectomy and Radiation Therapy in Endometrical Cancer: Current Status

BOOK TITLE: Advances in Obstetrics and Gynecology (Volume 2)

Author
1. Mehta Sumita
2. Rajaram Shalini
ISBN
9788184483048
DOI
10.5005/jp/books/10031_20
Edition
1/e
Publishing Year
2008
Pages
15
Author Affiliations
1. University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, MAMC and Lok Nayak Hospital, New Delhi, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, Lok Nayak Hospital, New Delhi, India, Babu Jagjivan Ram Memorial Hospital, New Delhi, India, Babu Jagjivan Ram Memorial Hospital, New Delhi; Indian Society of Colposcopy and Cervical Pathology (ISCCP), New Delhi, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, mehtadr@gmail.com
2. All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India, University College of Medical, Sciences and Guru Teg Bahadur Hospital, New Delhi, India, New Delhi, University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, India; Asia Oceania Research Organization on Genital Infections and Neoplasia (AOGIN), India, University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, India, University College of Medical Sciences and Guru Tegbahadur Hospital, Delhi 110095, India, University College of Medical Sciences and GTB Hospital, Delhi, Guru Teg Bahadur Hospital and University College of Medical Sciences, New Delhi, India, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, shalini_rajaram@rediffmail.com, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi,
Chapter keywords

Abstract

Seventy to eighty percent of endometrial cancers are diagnosed at an early stage and so the prognosis is generally good with 5 year overall and cancer specific survival rates of 80–85% and 90–95% respectively. Given the favourable outcome for majority of cases, the challenge is to effectively select those patients who are at increased risk of relapse and might benefit from more extensive surgical procedures and adjuvant therapies and to avoid over treatment of low-risk cases who would be exposed unnecessarily to the risk of excess morbidity. A pivotal study of the Gynecologic Oncology Group (GOG#33) concluded that the involvement of pelvic and para-aortic lymph nodes had significant implications for prognosis in endometrial carcinoma. For low-risk disease (stages IA and IB grade 1-2) no lymphadenectomy and no adjuvant RT is indicated. The use of postoperative RT should be limited to the group of patients at sufficiently high risk of locoregional recurrence (15% or over). A complete pelvic lymphadenectomy in high risk patients translates into a survival advantage. Para-aortic lymphadenectomy in high risk patients helps tailor adjuvant therapy but does not significantly improve survival.

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