Aim: To determine whether lymphadenectomy is associated with increased survival of women with stage IA endometrial cancer. Methods: Patients diagnosed with endometrial cancer from 2004 to 2013 and whose clinicopathologic data were recorded in the SEER database were examined. Propensity matching paired subjects with similar background variables. Before and after matching, Kaplan-Meier curves were drawn for comparison. Results: In 11,603 patients, cardiovascular disease and diabetes were the most common causes of death. Before matching, lymphadenectomy significantly improved the overall survival of stage IA/grade 3-4 patients (p = 0.013), but after matching, lymphadenectomy did not prolong survival for any grade. Sentinel lymph nodes biopsy can reduce the number of resected lymph nodes (p = 8.387e-10 in Wilcox test) but can't prolong survival. Conclusion: After matching, no significant difference in survival between lymphadenectomy and nonlymphadenectomy was observed for stage IA patients, sentinel lymph nodes group had fewer lymph node removed, but didn't affect survival.
Keywords: SEER; endometrial cancer; lymphadenectomy; propensity score matching; sentinel lymph nodes; stage IA; survival.