The Role Of Lymphadenectomy In The Treatment Of Early Stage Endometrial Cancer: A Meta Analysis

Objective To dicussion the role of lymphadenectomy in the treatment of early stage endometrial cancer.Data and Methods In this study,systematic evaluation was used to collect all domestic and foreign firms on early endometrial cancer lymph node dissection of clinical data,developed strict inclusion and exclusion criteria.Search Pubmed comprehensive database,Medline database,Cochrane library,EMBASE,limited English language.Manual search to retrieve all the current reference and research reports.Into the original research,evaluating the quality,extract the information and checked,remove non-research purposes and standards of the research literature,make a Meta-analysis by the end of the study.Hysterectomy,bilateral salpingo-oophorectomy,lymph node excision,with or without postoperative adjuvant therapy in the treatment group;Hysterectomy,bilateral salpingo-oophorectomy,with or without postoperative adjuvant therapy in the control group.RavMan4.2 provided by Cochrane was used for Meta Analysis.5-year survival rate and disease-free survival rate,intraoperative and postoperative complications were observed. Calculated the RR value of the various studies and the combined RR values,draw conclusions and guide the direction of future research.Result Six studies included a total of 2860 cases of patients meet the inclusion criteria.Among them,two randomized controlled clinical trials(RCT) and 4 retrospective study were include.Extract information line show the results of statistical analysis,hysterectomy and salpingo-oophorectomy plus lymph node excision group to simple hysterectomy and salpingo-oophorectomy group:first, 5-year overall survival rate,the combined RR=1.27,95%CI=[0.82,1.96],p=0.28, the difference was not statistically significant.Second,5-year disease-free survival rate,the combined RR=0.77,95%CI=[0.64,0.94],p=0.009,the difference was statistically significant.Third,the incidence of complications,the combined RR= 2.20,95%CI=[1.48,3.27],p＜0.0001,the difference was statistically significant.Conclusion The lymph node dissection and no lymph node dissection line were compared in patients with early stage endometrial cancer,5-year survival rate is no significant difference;5-year disease-free survival rate is relatively lower,the difference was statistically significant;The incidence of complications also increased, the difference was statistically significant.However,as the retrospective study were included in the literature,there is the possibility of bias occurred.Further conclusions to be drawn a number of high-quality,large sample randomized controlled clinical trials to prove.