Impact of systematic pelvic lymphadenectomy on short term postoperative quality of life in patients with early stage endometrial cancer

Abstract

Objective: to determine the potential impact of systematic lymphadenectomy vs. no lymphadenectomy on the perioperative change in QoL in patients undergoing surgical treatment for early stage endometrial cancer. Patients and methods: Patients scheduled for surgical treatment of clinically early stage endometrial cancer at the Department of gynecological oncology at the University Clinic of Gynecology and Obstetrics in Skopje, in the period January – December 2018 were approached for participation. Eligible subjects were divided into two groups: Group 1 (no LND) consisted of 60 patients who had hysterectomy plus bilateral salpingo-oophorectomy without lymph node dissection (LND); Group 2 consisted of 24 patients who had hysterectomy plus salpingo-oophorectomy plus systematic pelvic LND. Quality of life was quantified using a standardized and validated questionnaire (FACT-G) preoperatively and 30 days after surgical treatment. Results: The patients in the LND group exhibited statistically significantly lower postoperative scores for FACT-G (87.7 vs 75.8 for the no LND and LND groups respectively, p=0.002), as well as for the physical wellbeing domain (23.4 vs. 20, p=0.004) and emotional wellbeing domain (20.7 vs 17, p=0.008). Twelve patients from the group with no lymphadenectomy (20%) experienced a clinically significant decline in the postoperative QoL, compared to 12 patients (50%) in the lymphadenectomy group (p=0.006). Conclusion: There was a significant decrease in the postoperative QoL 30 days after surgery in patients that undergo systematic pelvic lymphadenectomy for early stage endometrial cancer compared to patients that do not.