Audit on adequacy and appropriateness of Lymphadenectomy in Endometrial Carcinoma

Anitha Thomas; Rachel Chandy; Grace Rebekah; Angeline Gnanamalar; Ajit Sebastian; Vinotha Thomas; Ramani Manoj Kumar; Abraham Peedicayil

Volume : VI, Issue : VI, June - 2016

Audit on adequacy and appropriateness of Lymphadenectomy in Endometrial Carcinoma

Anitha Thomas, Rachel Chandy, Grace Rebekah, Angeline Gnanamalar, Ajit Sebastian, Vinotha Thomas, Ramani Manoj Kumar, Abraham Peedicayil

Abstract :

 Aim : To audit the adequacy and appropriateness of pelvic and para aortic lymphadenectomy in endometrial carcinoma . Methodology : A retrospective audit on the operative and surgicopatholgical details of endometrial cancers operated in our institution from 2011–2013 was done to assess the adequacy and appropriateness of pelvic and para–aortic lymphadenectomy Results : Most patients (123/141, 87.2%) underwent pelvic lymphadenectomy and of these, 89 (72.7%) had more than 10 nodes removed. Only 29 patients underwent para–aortic node dissection and of these, 12 (24.1%) had more than 12 nodes excised.. Pelvic lymphadenectomy was performed as indicated by our guidelines in 110/121 (90.9%) whereas para–aortic lymphadenectomy was performed as required by our protocol in only 23/67 (34.3%). Conclusions : Pelvic lymph lymphadenectomy seems appropriate and adequate, whereas para aortic lymphadenectomy was inadequate as well as under done. Reasons for non–compliance need to be probed further. Frozen section or pre operative MRI could help in better decision making with regards to pelvic and para aortic lymphadenectomy.