Lymphadénectomie dans les cancers de l’endomètre de stade I

The indication and extent of lymph node dissection in the surgical management of endometrial cancers remain highly controversial. Randomized studies are necessary to verify its efficacy but there are no studies available, and probably they will lack for a long time considering the very large sample size required to show a small difference in survival. The trend towards a reduction in the routine use of external radiation therapy weakens the argument that radiation therapy makes adequate lymph node dissection useless. The balance stays between the risk for node involvement and the expected complications rate of the procedure. Lymph node dissection is advised whenever there is a non-negligible risk of node metastasis in a patient at low surgical risk.