Systematic lymphadenectomy for survival in patients with early-stage endometrial cancer: a meta-analysis

作者：Guo, Qinhao; Xu, Jianbo; Wang, Weijie; Gao, Jun; Yin, Xianghua^*

来源：International Journal of Clinical and Experimental Medicine, 2017, 10(3): 5029-5037.

• Systematic lymphadenectomy
• overall survival
• early-stage
• endometrial cancer
• meta-analysis

The efficacy of systematic lymphadenectomy is controversial for improving overall survival in patients with early-stage endometrial cancer. Thus, we performed a meta-analysis comparing the efficacy for overall survival between systematic and unsystematic lymphadenectomies. After an extensive literature search between January 2000 and August 2015, we analyzed nine studies (two randomized controlled trials and seven observational studies) involving 3871 patients with early-stage endometrial cancer. In all nine studies, systematic lymphadenectomy (SL) didn't improve overall survival (OS), compared with unsystematic lymphadenectomies (USL) (OR, 0.77; 95% CI, 0.52-1.13). Moreover, two RCTs showed no difference in OS between SL and USL (OR, 1.30; 95% CI, 0.94-1.79), whereas seven observational studies demonstrated that SL improved OS, compared with USL (OR, 0.57; 95% CI, 0.42-0.77). In three studies in which patients with low-risk endometrial cancer were included, SL failed to improve OS (OR, 0.96; 95% CI, 0.59-1.55), and two observational studies also showed that there was no difference in OS between SL and USL in the patients (OR, 0.70; 95% CI, 0.37-1.33). On the other hand, three studies in which patients with high-risk endometrial cancer were enrolled showed that SL didn't increase OS (OR, 0.47; 95% CI, 0.20-1.14), but two observational studies demonstrated that SL improved OS when compared with USL (OR, 0.34; 95% CI, 0.20-0.57). This meta-analysis suggests that SL failed to improve OS in patients in early-stage endometrial cancer, especially those with low-risk disease.

• 出版日期2017
• 单位扬州大学