Prognostic significance of para-aortic node metastasis in endometrial cancer:Japanese Gynecologic Oncology Group Study JGOG2043 post hoc analysis
- Author:
Yosuke KONNO
1
;
Michinori MAYAMA
;
Kazuhiro TAKEHARA
;
Yoshihito YOKOYAMA
;
Jiro SUZUKI
;
Nobuyuki SUSUMU
;
Kenichi HARANO
;
Satoshi NAKAGAWA
;
Toru NAKANISHI
;
Wataru YAMAGAMI
;
Kosuke YOSHIHARA
;
Hiroyuki NOMURA
;
Aikou OKAMOTO
;
Daisuke AOKI
;
Hidemichi WATARI
Author Information
- Publication Type:Original Article
- From:Journal of Gynecologic Oncology 2025;36(4):e57-
- CountryRepublic of Korea
- Language:English
-
Abstract:
Objective:This study aimed to assess the prognostic significance of para-aortic lymphadenectomy (PALX) and para-aortic lymph node metastasis in endometrial cancer (EC) patients at risk of post-operative recurrence.
Methods:Japanese Gynecologic Oncology Group (JGOG) 2043 was a randomized controlled trial assessing the efficacy of adjuvant chemotherapy in EC patients at risk for postoperative recurrence. A retrospective analysis included patients who underwent pelvic lymphadenectomy (PLX) alone or both PLX and PALX in JGOG2043. Data on positive lymph nodes and other clinicopathological risk factors were collected.
Results:PLX and PALX were performed on 402 patients, while PLX alone was conducted on 250 patients. Evaluating the effect of PALX on survival was challenging through a comparison of the outcomes of the 2 cohorts since PALX was predominantly administered to higher-risk patients. Patients with 2 or more metastases in para-aortic nodes exhibited significantly poorer overall survival than those with no or 1 metastasis, respectively (p<0.001, p=0.031).Multivariate analysis revealed that 2 or more metastases in para-aortic nodes is independent risk factors for disease-free survival (hazard ratio [HR]=1.72; 95% confidence interval [CI]=1.10–2.72; p=0.019) and are marginally significant for overall survival (HR=1.58; 95% CI=0.92–2.72; p=0.096) compared to no or a single metastasis.
Conclusion:The clinical relevance of PALX was challenging to evaluate in the JGOG2043 cohort; however, the presence of 2 or more para-aortic node metastases was identified as an independent unfavorable prognostic factor in EC patients at risk of recurrence.
