Health related quality of life and symptoms after pelvic lymphadenectomy or radiotherapy vs. no adjuvant regional treatment in early-stage endometrial carcinoma: A large population-based study

Lonneke V. van de Poll-Franse*, Johanna M. A. Pijnenborg, Dorry Boll, M. Caroline Vos, Hetty van den Berg, Marnix L. M. Lybeert, Karin de Winter, Roy F. P. M. Kruitwagen

*Corresponding author for this work

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Objectives. Routine lymphadenectomy (LA) in early stage endometrial cancer does not improve survival. However, in the absence of lymph node metastasis, radiotherapy (RT) could be withheld and hence could result in less morbidity. Our aim was to evaluate health related quality of life (HRQL) in endometrial cancer survivors that received routine pelvic LA without RT compared to no LA, but RT in the presence of risk factors. Methods. Stage I-II endometrial cancer survivors diagnosed between 1999 and 2007 were selected from the Eindhoven Cancer Registry. Survivors completed the SF-36 and the EORTC-QLQ-EN24. ANCOVA and multiple linear regression analyses were applied. Results. 742 (77%) of the endometrial cancer survivors returned a completed questionnaire. 377 (51%) had received no LA nor RT (LA-RT-), 198 (27%) had received LA+RT-, 153 (21%) LA-RT+ and 14 patients (2%) had received both. LA+ women reported as higher lymphedema symptom scores (25 vs. 20, p = 0.04). Women who were treated with RT reported higher gastrointestinal symptom scores vs. those who did not (23 vs. 16, p = 0.04). HRQL scales were comparable between all four treatment groups. Conclusion. Despite distinct symptom patterns among women who received LA or RT, no clinically relevant differences in HRQL were observed when compared to women not receiving adjuvant therapy. Using LA to tailor adjuvant pelvic radiotherapy and prevent over-treatment in low-risk patients cannot be recommended.
Original languageEnglish
Pages (from-to)153-160
JournalGynecologic Oncology
Issue number1
Publication statusPublished - Oct 2012


  • Endometrial cancer
  • Pelvic lymphadenectomy
  • Radiotherapy
  • Symptoms
  • Health related quality of life

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