Postoperative complications after pelvic lymphadenectomy for the surgical staging of endometrial cancer

Objective: To assess whether pelvic lymphadenectomy at surgical staging for endometrial carcinoma is an independent risk factor for the occurrence of postoperative complications. Methods: Women with uterine cancer who underwent radical abdominal hysterectomy type I or II of Piver-Rutledge with or without pelvic lymph nodes dissection were considered. The occurrence of intraoperative and early postoperative complications (deep vein thrombosis, lymphocysts, febrile morbidity, extraoperative site infections, wound dehiscence, relaparotomy, and death) was prospectively recorded. Non parametric tests, receiver characteristic curve analysis, and multiple logistic regressions were used for statistical purposes. Results: Two hundred six subjects were enrolled, of whom 133 underwent pelvic lymphadenectomy. The rate of postoperative complications was 26.7% (55 of 206). Women with complications had a higher median (range) number of lymph nodes removed than those without complications (17 [3-62] versus 11 [1-74], P<.01). The performance of a type 11 hysterectomy (OR = 2.49. P <.05) and the removal of more than 14 lymph nodes (OR=3.05, P<.005) were significantly associated with the occurrence of at least one complication. Multiple logistic regression revealed that, after adjustment for the type of surgery, the removal of more than 14 nodes was the only condition associated with postoperative complications (OR = 2.56, P <.01). The only variable significantly associated with the development of two postoperative complications was the removal of more than 19 nodes (OR = 9.7, P <.01). Conclusions: The extension of retroperitoneal lymph nodes (more than 14) dissection is an independent risk factor for the occurrence of postoperative complications in patients undergoing surgical staging for endometrial carcinoma. J. Surg. Oncol. 2001;78:232-240. (C) 2001 Wiley-Liss, Inc.