Low-risk corpus cancer: Is lymphadenectomy or radiotherapy necessary?
June 1, 2000
What intraoperative pathologic indicators predict a group of uterine cancers that would not require lymphadenectomy or adjuvant radiotherapy?
Comparisons:
Hysterectomy/BSO with vs without lymphadenectomy
Tumor size ≤2cm vs > 2cm
PFS and DSS
1984-1993
grade 1/2 uterine cancer
myometrial invasion < 50%
intraoperative evidence of macroscopic extrauterine spread
n=328
5 yr DSS: 97%
5yr PFS: 96%
0 patients with tumor ≤2cm had positive LN or died of disease
LVSI vs no LVSI 5yr DSS: 77% vs. 98% (SS)
Patients with grade 1/2 endometrioid cancers, <50% myometrial invasion, and without evidence of macroscopic disease may be treated with hysterectomy only.