SGO: Current surgical staging of uterine cancer inadequate

Endometrial cancer spreads to distant lymph nodes more often than was previously believed, suggesting that current lymph node sampling practices may not be sufficient for adequate surgical staging, according to research findings presented at the Society of Gynecologic Oncologists' 39th Annual Meeting on Women's Cancer in Tampa, FL.

In a single-institution, prospective study of women with endometrial cancer, Andrea Mariani, MD, PhD, of the Mayo Clinic in Rochester, MN, and colleagues investigated whether current surgical guidelines for lymph node dissection in endometrial cancer allowed detection of all affected lymph nodes.

The researchers found that metastatic spread of endometrial cancer to the higher para-aortic nodes was more common than previously believed. Of those with metastatic involvement of the lower para-aortic nodes, 62% were found to have disease in the higher para-aortic nodes. A surgical approach that does not sample the higher para-aortic nodes above the inferior mesenteric artery could potentially miss 38% to 46% of patients with involved upper lymph nodes, the study found.

In addition to offering guidelines about patients in whom higher para-aortic node sampling is indicated, the study confirmed earlier research findings that a subset of patients with endometrial cancer do not benefit from lymph node removal. Improved surgical guidelines should allow more appropriate treatment of all patients with endometrial cancer.

More details are available online at http://www.sgo.org/ content.aspx?id=58.