"Initial low-risk endometrial cancer, need to reconsider the need for lymph node resection"
Nov 06, 2024
A research team led by Kim Ki-dong, a professor of obstetrics and gynecology at Seoul National University Bundang Hospital, has published the results of a study that confirmed that lymph node resection is not necessary for endometrial cancer patients classified as low risk in blood and imaging tests, even if the degree of differentiation is high as Grade 3.
Differentiation refers to the degree to which the structure and function of cancer cells are specialized and mature, and is used as an indicator to determine the degree of cancer progression. It is classified from Grade 1 to 4, and the larger the number, the faster the division rate, so transition occurs more easily.
Endometrial cancer is the most common type of female genital cancer, with about 73% of patients initially detecting it, and the 5-year survival rate ranges from 85 to 91%.
Endometrial cancer surgery includes lymph node resection. Lymph node resection helps detect and prevent metastasis of cancer, but there is a high risk of increased postoperative complications. Some studies have shown that for early low-risk endometrial cancer, lymphadenectomy does not contribute to improved survival, resulting in more complications than patients who did not undergo resection.
Accordingly, there has been a movement to omit lymph node resection or replace it with lymph node biopsy. However, if the degree of differentiation is high with Grade 3, the risk of metastasis and recurrence is known to be high, so most patients with early low-risk endometrial cancer are performing lymph node resection, and there is no clear guideline for this, so controversy over the need to omit lymph node resection continues.
In response, a research team led by Professor Kim Ki-dong at Seoul National University Bundang Hospital conducted a retrospective study to evaluate the risk of lymph node metastasis and recurrence on 36 early-risk endometrial cancer patients of Grade3 who underwent uterine extraction at seven medical institutions from 2013 to 2021. Low-risk criteria refer to patients with less than 50% uterine fibrotic infiltration, normal serum CA-125 levels, and MRI of cancer cells not leaving the uterine body.
As a result of the study, the lymph node metastasis rate was only 2.8%, and the 5-year recurrence-free survival rate was 88.7%. The results of this study are meaningful as they suggest that the need for lymph node resection can be reconsidered by confirming that lymph node metastasis is rare and the prognosis is good when classified as low-risk endometrial cancer in preoperative imaging and blood tests.
Kim Ki-dong, a professor of obstetrics and gynecology at Seoul National University Bundang Hospital, said "The results of a study that raised the possibility of improving patients' quality of life while avoiding unnecessary surgery by reducing lymph node resection unless absolutely necessary." Subsequently, the researchers plan to conduct a follow-up study exploring molecular and genetic indicators that can predict the risk of metastasis and recurrence in the low-risk endometrial cancer patient group of Grade3, which is expected to enable more precise patient-specific treatment strategies to be developed"It revealed its future plans.
The paper was recently published in the international journal 『The European Journal of Obstetrics and Gynecology』. 논문명은 'Exploring metastasis and recurrence patterns in low-risk grade 3 endometrial cancer: A multicenter retrospective cohort study'이다.
Differentiation refers to the degree to which the structure and function of cancer cells are specialized and mature, and is used as an indicator to determine the degree of cancer progression. It is classified from Grade 1 to 4, and the larger the number, the faster the division rate, so transition occurs more easily.
Endometrial cancer is the most common type of female genital cancer, with about 73% of patients initially detecting it, and the 5-year survival rate ranges from 85 to 91%.
Endometrial cancer surgery includes lymph node resection. Lymph node resection helps detect and prevent metastasis of cancer, but there is a high risk of increased postoperative complications. Some studies have shown that for early low-risk endometrial cancer, lymphadenectomy does not contribute to improved survival, resulting in more complications than patients who did not undergo resection.
Accordingly, there has been a movement to omit lymph node resection or replace it with lymph node biopsy. However, if the degree of differentiation is high with Grade 3, the risk of metastasis and recurrence is known to be high, so most patients with early low-risk endometrial cancer are performing lymph node resection, and there is no clear guideline for this, so controversy over the need to omit lymph node resection continues.
In response, a research team led by Professor Kim Ki-dong at Seoul National University Bundang Hospital conducted a retrospective study to evaluate the risk of lymph node metastasis and recurrence on 36 early-risk endometrial cancer patients of Grade3 who underwent uterine extraction at seven medical institutions from 2013 to 2021. Low-risk criteria refer to patients with less than 50% uterine fibrotic infiltration, normal serum CA-125 levels, and MRI of cancer cells not leaving the uterine body.
As a result of the study, the lymph node metastasis rate was only 2.8%, and the 5-year recurrence-free survival rate was 88.7%. The results of this study are meaningful as they suggest that the need for lymph node resection can be reconsidered by confirming that lymph node metastasis is rare and the prognosis is good when classified as low-risk endometrial cancer in preoperative imaging and blood tests.
Kim Ki-dong, a professor of obstetrics and gynecology at Seoul National University Bundang Hospital, said "The results of a study that raised the possibility of improving patients' quality of life while avoiding unnecessary surgery by reducing lymph node resection unless absolutely necessary." Subsequently, the researchers plan to conduct a follow-up study exploring molecular and genetic indicators that can predict the risk of metastasis and recurrence in the low-risk endometrial cancer patient group of Grade3, which is expected to enable more precise patient-specific treatment strategies to be developed"It revealed its future plans.
The paper was recently published in the international journal 『The European Journal of Obstetrics and Gynecology』. 논문명은 'Exploring metastasis and recurrence patterns in low-risk grade 3 endometrial cancer: A multicenter retrospective cohort study'이다.
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