Role of the Appropriateness of the Pelvic Lymphadenectomy and Adjuvant Radiation Therapy in Early-Stage Poorly Differentiated Endometrial Carcinoma

Purpose: With this work, we intend to investigate the prognostic role of the pelvic lymphadenectomy, analyzing the pattern of recurrence in poorly differentiated endometrial carcinoma. Methods and Materials: Our study analyzes a total of 98 patients affected by early-stage (T1/T2) poorly differentiated endometrial carcinoma. Detailed data concerning clinical presentation, pathology, adjuvant treatment, and outcomes were collected and correlated with disease-free survival (DFS), further distinguished in local and distant DFS, and overall survival (OS). The extent of the lymphadenectomy was considered appropriated when a number of 12 lymph nodes were removed. Results: The only characteristic significantly associated with locoregional DFS was the use of adjuvant radiation therapy (p: 0.003), whereas the use of adjuvant radiation therapy (RT, p: 0.004), the appropriateness of lymphadenectomy (p: 0.019), and the higher age (> 65 years, p: 0.037) are associated with distance DFS. The only significant variable associated with OS was the higher age (p: 0.025). On multivariate analysis, RT was correlated (p: 0.017) with locoregional DFS, whereas RT (p: 0.019) and age (p: 0.048) were correlated with distance DFS. The multivariate analysis of OS showed that the only parameter associated was the age (p: 0.047). Conclusions: The results of our study underline the importance of an appropriate lymphadenectomy and the selection of the correct adjuvant strategy in the treatment of early-stage poorly differentiated endometrial carcinoma.