An evaluation of para-aortic and pelvic lymph node metastases in patients with endometrial carcinoma

During 1979-1986, 101 patients with an endometrial carcinoma were treated. Eighty-four of these patients underwent a para-aortic lymph node (PAN) biopsy at the time of their initial surgery, eight of whom (9.5%) were found to have a positive PAN. The incidence of positive PAN as per each clinical stage, was as follows: stage I, 2.0%; II, 11.5%; III, 50%; and, IV, 33.3%. Positive pelvic nodes were found in 19.2% of the patients, per the following stages: stage I, 6.1%; II, 32%; and, III & IV, 100%. This finding suggests that PAN metastasis occurs after the pelvic nodes are involved. A 5-year survival rate of approximately 50% is expected even in patients with a positive PAN. Thus our study concludes that an evaluation of para-aortic and pelvic lymph nodes is important for the management of an endometrial carcinoma.