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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: OBJECTIVE, METHODS, METHODS, METHODS, METHODS, METHODS, RESULTS. Meshes: Disease-Free Survival, Endometrial Neoplasms, Female, Humans, Kaplan-Meier Estimate, Lymph Node Excision, Lymph Nodes, Lymphatic Metastasis, Middle Aged, Multivariate Analysis, Neoplasm Staging, Pelvis, Prognosis, Proportional Hazards Models, Survival Rate.
user
Does para-aortic lymphadenectomy improve survival in patients with intermediate to high-risk endometrial carcinoma? Context: Surgical staging of endometrial carcinoma is practiced to identify the true extent of disease. The impact of para-aortic lymphadenectomy (PALD) on survival is unproven. The purpose of this study was to determine if a staging procedure that includes PALD is associated with improved survival in endometrial carcinoma patients who had been surgically staged. Retrospective review of patients' records. Ajou University Hospital, a tertiary care hospital in South Korea. One hundred and sixty patients with endometrial carcinoma. We retrospectively analyzed a total of 160 FIGO stage I-III endometrial carcinoma patients without grossly metastatic para-aortic lymph nodes, who underwent surgery between 1994 and 2007. Exclusion criteria included presurgical radiation, stage IV disease and sarcomas. Two groups were identified: patients who underwent pelvic lymphadenectomy (PLD) and PALD (n=85) versus those who underwent PLD alone (n=75). Survival was analyzed using Kaplan-Meier method and Cox proportional hazards model. Disease-free and overall survival. Overall, patients who underwent PALD demonstrated improved 5-year disease-free survival (81.0 vs 91.2%) and overall survival (85.8 vs 96.2%) compared to those who underwent PLD alone (p=0.019 and p=0.039, respectively). After multivariate analysis, patients' age (p=0.028), FIGO stage (p<0.001) and lymphadenectomy (p=0.014) were independent prognostic factors. The type of lymphadenectomy did not affect survival of low-risk patients. In intermediate to high-risk patients, PALD improved disease-free survival and showed a trend toward improvement of overall survival.
assistant
These data demonstrate that PALD has a potentially therapeutic benefit on survival in surgically staged patients with intermediate to high-risk endometrial carcinoma. Final Decision: yes