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Introduction/Background Primary surgery by total hysterectomy and bilateral oophorectomy is the widely accepted treatment for low grade (Grade 1; G1) low stage endometrial cancer (EC) worldwide. Although surgical lymph node staging is unanimously agreed for higher risk ECs for targeted therapy, there is no universal protocol regarding lymph node dissection in low grade ECs. This is not routinely done in the NHS and hence we investigated of its role in predicting overall survival and recurrence. Methodology We collected data of 238 cases of confirmed post operative G1 endometrial cancer who were operated at Oxford University Hospitals between 2009 – 2019. We then analysed 32 patients who had lymph node dissection (18) or/and relapse of their disease (14) by IBM©SPSS Statistics 22.0. Univariate and multivariate Cox proportional hazards analysis was conducted to assess the potential risk factors for relapse and mortality. Results Of the 18/32 patients who had lymph nodes dissection, none had recurrence. These patients all had higher grade components in their pre-operative histology leading to the decision to LND. Their post operative histology all confirmed G1 with varying stages. Only 1/32 patients had lymph nodes resected and had recurrence later. In other words, among the relapse group, 1/14 patients (0.049%, p value 0.88) had lymph node involvement. Lymph node dissection was performed in systematic fashion in 13/18 patients and sentinel node mapping in 5/18. Multivariable Cox proportional hazards analysis for the risk of recurrence did not identify lymph node involvement as an independent risk factor (p value .981) in this study. Conclusion The result of this study suggests that lymph node involvement in early grade EC is not a direct risk factor for recurrence and LND has no significant benefit on overall survival. Acknowledging the small data size, we recommend LND should be considered per case and not routine. Disclosures All authors declare that they have no conflict of interest.
Sadeghi et al. (Fri,) studied this question.