The role of lymphadenectomy in uterine sarcoma: a clinical practical approach based on retrospective analysis

BACKGROUND: Uterine sarcomas are rare, highly aggressive tumors with an unfavorable prognosis. Only limited data on treatment and outcome are available and the role of lymphadenectomy is controversial for this particular tumor type.

PATIENTS AND METHODS: By performing a retrospective analysis, through clinical practice, we analyzed the impact of lymphadenectomy on patient outcome.

RESULTS: Out of 52 patients, 48 women underwent surgical treatment. Among those, lymphadenectomy was performed in 58%. 10% underwent pelvic and paraaortic lymphadenectomy and 48% underwent pelvic lymphadenectomy alone.

CONCLUSION: In our cohort, surgeons tended to perform paraaortic-plus-pelvic or pelvic-alone lymphadenectomy irrespective of the presence or absence of enlarged lymph nodes. Patients who underwent lymphadenectomy showed a better survival. This observation might indicate a potential role for systematic lymphadenectomy in the surgical treatment of uterine sarcoma. We review on clinical operative decisions, critically with regard to current evidence.