Low-risk corpus cancer: is lymphadenectomy or radiotherapy necessary?

Am J Obstet Gynecol. 2000 Jun;182(6):1506-19. doi: 10.1067/mob.2000.107335.


Objective: The objective of this study was to find readily ascertainable intraoperative pathologic indicators that would discriminate a subgroup of early corpus cancers that would not require lymphadenectomy or adjuvant radiotherapy.

Study design: Between 1984 and 1993, a total of 328 patients with endometrioid corpus cancer, grade 1 or 2 tumor, myometrial invasion < or =50%, and no intraoperative evidence of macroscopic extrauterine spread were treated surgically. Pelvic lymphadenectomy was performed in 187 cases (57%), and nodes were positive in nine cases (5%). Adjuvant radiotherapy was administered to 65 patients (20%). Median follow-up was 88 months.

Results: The 5-year overall cancer-related and recurrence-free survivals were 97% and 96%, respectively. Primary tumor diameter and lymphatic or vascular invasion significantly affected longevity. No patient with tumor diameter < or =2 cm had positive lymph nodes or died of disease.

Conclusion: Patients who have International Federation of Gynecology and Obstetrics grade 1 or 2 endometrioid corpus cancer with greatest surface dimension < or =2 cm, myometrial invasion < or =50%, and no intraoperative evidence of macroscopic disease can be treated optimally with hysterectomy only.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Endometrial Neoplasms / pathology
  • Endometrial Neoplasms / radiotherapy*
  • Endometrial Neoplasms / surgery*
  • Female
  • Humans
  • Hysterectomy
  • Lymph Node Excision*
  • Lymph Nodes / pathology
  • Middle Aged
  • Myometrium / pathology
  • Neoplasm Invasiveness / pathology
  • Neoplasm Recurrence, Local
  • Pelvis
  • Peritoneum / pathology
  • Postoperative Complications
  • Prognosis
  • Radiation Injuries
  • Survival Analysis