Author(s)

Motoki Matsuura^*, Akimasa Takahashi, Hidetaka Nomura, Maki Matoda, Sanshiro Okamoto, Hiroyuki Kanao, Kohei Omatsu, Kazuyoshi Kato, Kuniko Utsugi, Nobuhiro Takeshima

Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Japan.

Aim: While cytoreductive surgery should be considered for patients with regional recurrence of endometrial cancer, the management of isolated para-aortic lymph node recurrence remains controversial. We investigated the frequency of isolated recurrence in the para-aortic lymph nodes and the effectiveness of surgery for such recurrence. Methods: A retrospectively maintained endometrial cancer database at the Cancer Institute Hospital in Japan was reviewed to identify sites of metastasis and recurrence. Results: A total of 2322 patients with endometrial cancer underwent primary treatment with systemic lymphadenectomy between 1984 and 2015. Systematic pelvic and para-aortic lymph node dissection was performed in 889 patients (Group 1), while 1433 patients underwent dissection of only the pelvic lymph nodes (Group 2). Although 16 patients (1.1%) in Group 2 had isolated para-aortic recurrences, only 3 patients (0.3%) in Group 1 had documented recurrences in the para-aortic lymph nodes (p = 0.043). Although second recurrence occurred in 30.0% of patients who underwent surgical recurrence treatment, second recurrence occurred in 77.8% of patients who underwent non-surgical recurrence treatment (p = 0.037). In addition, the overall survival rate for patients who underwent surgical recurrence treatment (80.0%) was significantly higher than that for patients who underwent non-surgical recurrence treatment (33.3%) (p = 0.026). Conclusions: Patients who underwent dissection of only the pelvic lymph nodes had a higher frequency of isolated recurrence in the para-aortic lymph nodes. In addition, a relatively good prognosis could be achieved with surgical treatment for isolated recurrence in the para-aortic lymph nodes, which was better than that achieved using non-surgical methods.

Endometrial Cancer, Recurrence, Isolated Para-Aortic Nodal Recurrence

Matsuura, M. , Takahashi, A. , Nomura, H. , Matoda, M. , Okamoto, S. , Kanao, H. , Omatsu, K. , Kato, K. , Utsugi, K. and Takeshima, N. (2018) Isolated Para-Aortic Nodal Recurrence in Endometrial Cancer. Open Journal of Obstetrics and Gynecology, 8, 669-675. doi: 10.4236/ojog.2018.87071.