62例阴茎鳞状细胞癌治疗的临床分析

目的:提高阴茎鳞状细胞癌的治疗水平,寻求鳞状细胞癌合理有效的治疗方法。方法:回顾分析62例病理活检证实阴茎鳞状细胞癌治疗的临床资料。结果:除8例拒绝手术治疗外,其余54例均行手术治疗。45例行阴茎部分切除术,9例行阴茎全切加会阴部尿道造口术治疗,腹股沟淋巴结活检术31例,腹股沟淋巴结病理阳性9例,总活检阳性率为29.0%,行腹股沟淋巴结清扫术。5例行阴茎部分切除者3年内复发,再行阴茎全切除并尿道会阴部造口术及髂腹股沟淋巴清扫术。高分化鳞癌43例,中分化鳞癌7例,低分化鳞癌4例;9例术前淋巴结活检有癌转移,腹股沟淋巴结清扫均有转移,盆腔淋巴结转移4例,淋巴结清扫发现转移2例。按照Jackson分期:I期29例;II期13例;III期8例;V期4例。本组62例患者中44例获定期随访2-7年,随访率70.9%。3年、5年生存率分别为90.9%、75%。非手术治疗5年生存率仅为50%。结论:外科手术治疗是目前治疗阴茎鳞状细胞癌的有效方法,淋巴结清扫根据临床分级具体处理,手术联合术后化、放疗是否可减少复发及提高生存率,还需进一步研究。     

阴茎癌32例诊治体会

目的：探讨阴茎癌有效合理的诊断及治疗方法。方法：回顾性分析32例阴茎癌患者的临床资料,其中鳞状细胞癌29例,鳞状上皮乳头状瘤恶变2例,疣状癌1例。31例行手术治疗,首次治疗行单纯肿瘤切除＋包皮环切术＋放疗3例,阴茎部分切除术27例,阴茎全切＋尿道会阴部造口术1例,其中行双侧腹股沟淋巴结清扫术4例。结果：28例获得随访,行单纯肿瘤切除＋包皮环切术中1例于手术后3年复发和2例于手术后3月复发而行阴茎部分切除术,行阴茎部分切除术者2年和5年及10年生存率分别为92%、82%和45%,行阴茎全切除术者随访6年至今仍健在。结论：阴茎部分切除术是治疗阴茎癌合理有效的方法,且应尽早治疗。证实有淋巴结转移者应积极行腹股沟淋巴结清扫术。     

阴茎癌32例诊治体会

目的:探讨阴茎癌有效合理的诊断及治疗方法。方法:回顾性分析32例阴茎癌患者的临床资料,其中鳞状细胞癌29例,鳞状上皮乳头状瘤恶变2例,疣状癌1例。31例行手术治疗,首次治疗行单纯肿瘤切除+包皮环切术+放疗3例,阴茎部分切除术27例,阴茎全切+尿道会阴部造口术1例,其中行双侧腹股沟淋巴结清扫术4例。结果:28例获得随访,行单纯肿瘤切除+包皮环切术中1例于手术后3年复发和2例于手术后3月复发而行阴茎部分切除术,行阴茎部分切除术者2年和5年及10年生存率分别为92%、82%和45%,行阴茎全切除术者随访6年至今仍健在。结论:阴茎部分切除术是治疗阴茎癌合理有效的方法,且应尽早治疗。证实有淋巴结转移者应积极行腹股沟淋巴结清扫术。     

阴茎癌术后短期肺转移3例报道并文献复习

目的:探讨阴茎癌术后短期肺转移的疾病进展、影像学表现、病理、治疗及预后情况。方法:通过回顾分析3例阴茎癌肺转移患者的临床资料,结合相关文献进行讨论。结果:3例患者,平均年龄65岁,术前平均体质量指数(body mass index, BMI)为21.2 kg/m²,术前胸部CT均未见明显肺转移。3例患者术前均可触及肿大腹股沟淋巴结,其中1例盆腔磁共振可见淋巴结肿大。活检病理2例为低分化鳞状细胞癌,1例为中分化鳞状细胞癌。1例患者接受了阴茎部分切除术+腹股沟及盆腔淋巴结清扫术,2例患者接受阴茎部分切除术+腹股沟淋巴结清扫术。术后病理肿瘤直径3.0～5.2 cm,均提示阴茎低分化鳞状细胞癌。免疫组化：CK(+)、p40(+)、Vimentin(+)、CK5/6(+)、HCK(+)、p63(+), Ki-67均大于70%。3例患者术后1个月复查胸部CT均提示多发结节。其中1例患者术后1个月出现咯血症状,腹股沟区可触及肿块,肺结节穿刺病理证实阴茎癌肺转移。术后3例患者总生存期均≤5个月。结论:阴茎癌术后短期出现肺转移临床少见,术前多有区域淋巴结转移,术后进展迅速,可合并有...     

阴茎癌外科治疗36例分析

36例阴茎癌其中鳞状细胞癌34例,鳞状上皮乳头状瘤恶变2例;行阴茎部分切除术32例,阴茎全切除并尿道会阴部造口术4例;行腹股沟淋巴结清扫术14例(22侧),行髂淋巴结清扫术4例(6侧);伴淋巴结转移者行患侧放疗.阴茎部分切除术后3例发生尿道外口狭窄,经反复尿扩后好转;行腹股沟淋巴结清扫患者中8例(10侧)发生皮瓣感染坏死,6例(7侧)经换药后治愈,2例(3侧)经植皮后愈合;30例获得随访,1、2、5年生存率分别为80.0%、70.6%和63.0%.     

不同时期淋巴结清扫术对阴茎癌预后的影响

目的 回顾性分析295例阴茎癌的临床资料,比较阴茎癌不同时期行双侧腹股沟淋巴结清扫对预后的影响,探讨阴茎癌有效合理的手术治疗方法。方法 回顾性调查随访哈尔滨医科大学附属第三医院和解放军第二一一医院的295例阴茎癌患者,收集年龄、职业、病理、Jackson分期、淋巴结转移等可能影响其生存情况的因素。按照一期是否行双侧腹股沟淋巴结清扫术将患者分为两组,采用Log-rank检验、Cox回归等统计方法分别比较淋巴结有转移情况和无转移情况下两组患者的生存预后。结果 295例患者均获得随访。一期手术患者212人,二期手术患者83人。无淋巴结转移情况下,一期组5年生存率为96.12%;二期组为80.00%,有淋巴转移情况下,一期组5年生存率为91.30%,二期组为50.80%,不同淋巴结转移情况下一期组生存率均高于二期组(χ²=37.406,P＜0.001;χ²=53.427,P＜0.001)。经Cox回归分析,不同时期行淋巴结清扫术、年龄、化疗药物对预后的影响显著。结论 阴茎部分切除术或阴茎全切除术同时行双侧腹股沟淋巴结清扫术是治疗阴茎癌十分合理和有效的方法,根治术同期行腹股沟淋巴结转移生存率与二期行双侧腹股沟淋巴结清扫术有显著差异。     

阴茎疣状癌5例临床分析

目的探讨阴茎癌的特殊类型疣状癌的术前诊断和手术方法。方法回顾性分析5例阴茎疣状癌患者的临床、病理资料。结果 5例患者均包茎或包皮过长;肿瘤直径1.0～3.5 cm;基底位于阴茎头部4例,其中侵犯冠状沟近侧1例;位于包皮内板1例。5例均在术前活检确诊。3例行阴茎部分切除术;2例行肿瘤局部切除术,其中1例术后9月复发再行阴茎部分切除术;1例行腹股沟淋巴结活检。病理检查见肿瘤细胞分化好,标本切缘阴性。4例随访0.5-7年未见复发,二次手术者随访6年无复发。结论阴茎疣状癌细胞分化良好,生物学特性为局部侵袭性生长,很少发生区域淋巴结或远处转移。     

阴茎切除联合改良腹股沟淋巴结清扫术治疗阴茎癌的疗效观察

目的探讨阴茎切除联合改良腹股沟淋巴结清扫术治疗阴茎癌的临床疗效。方法广东梅州市人民医院2015年1月至2017年8月收治并确诊为阴茎癌患者9例,2例采用阴茎全切除术,7例采用阴茎部分切除联合改良腹股沟淋巴结清扫术,治疗结束后分析手术情况,并对住院时间及术后并发症情况进行统计。结果 9例患者手术时间(327.78±65.83)min,术中出血量(71.11±15.31)ml,住院时间(18.36±1.25)d;术后并发症包括皮瓣坏死需植皮1例,切口感染1例,皮下积液1例及下肢淋巴水肿2例。结论治疗阴茎癌采用阴茎全切除术或部分切除术联合改良腹股沟淋巴结清扫术可取得较好的手术效果,并能控制术后并发症,改善预后。     

阴囊Paget病的诊疗分析(附28例报告并文献复习)

目的:探讨阴囊Paget病的临床特点,提高对其诊断、治疗及预后的认识.方法:回顾性分析我院28例阴囊Paget病的诊治资料,复习相关文献,并进行随访.28例患者术前均经病理活检证实为阴囊Paget病.Ray分期标准,A1期15例,A2期8例,B期5例.手术治疗27例,其中21例行根治性病灶切除术,6例因病灶较大行病灶扩大切除及股部带蒂皮瓣修补术,5例经病理证实腹股沟淋巴结有转移者行单侧或双侧腹股沟淋巴结清扫术.放疗、化疗1例.结果:术后均经病理学检查确诊.术后26例获随访,随访3个月-15年,平均4年.2例分别于术后5个月、1年局部复发,均再次手术治愈.1例术后2年死于多发骨转移.其余无局部复发及转移.结论:阴囊Paget病是一种易发于老年男性的少见恶性肿瘤,极易误诊为阴囊湿疹、皮炎等疾病,确诊需依靠病理检查;治疗以病灶根治切除术为首选方法,早期治疗预后较好.     

右足底鳞癌同侧下肢皮肤广泛转移一例

患者男性,46岁.2006年3月发现右侧足底部溃疡,面积约1.5 cm×1.5 cm,在当地医院冷冻治疗后结痂愈合.1周后发现右侧腹股沟淋巴结肿大伴右下肢肿胀,于2006年4月在当地医院行足底病灶活检,病理诊断为鳞状细胞癌Ⅰ级,行右侧腹股沟淋巴结清扫术,术后病理学检查5枚腹股沟淋巴结中有3枚转移.     

前哨淋巴结检测术在早期宫颈癌诊疗中的研究进展

宫颈癌是最常见的妇科恶性肿瘤,淋巴结转移状态是影响宫颈癌预后和生存率的重要因素。根据FIGO分期,Ia2期以上的患者常行广泛性子宫切除术和盆腔淋巴结清扫术。早期宫颈癌患者淋巴结转移率低,而盆腔淋巴结清扫可能会导致许多并发症的出现,严重影响患者的术后生活质量。前哨淋巴结（sentinel lymph node,SLN）是接受肿瘤淋巴引流的第一站淋巴结,能反映整个盆腔淋巴结的转移状况,其应用使大多数早期宫颈癌患者避免了不必要的盆腔淋巴结清扫。通过对前哨淋巴结的研究,进而判断盆腔淋巴结的转移状况,为早期宫颈癌的治疗术中是否切除盆腔淋巴结及对其预后评估提供一定的依据。     

宫颈癌淋巴结转移的高危因素及预后分析

背景与目的:盆腔淋巴结转移是影响宫颈癌预后的主要危险因素,但综合淋巴结转移的相关因素与预后分析的报道鲜见。本文综合分析宫颈癌淋巴结转移的高危因素、分布规律及预后因素,探讨淋巴结转移风险的评估以及淋巴结转移的治疗。方法:对205例在中山大学肿瘤防治中心妇科行广泛全宫切除加盆腔淋巴结清扫的病例进行回顾性分析。结果:总体盆腔淋巴结转移率为24.4%(50/205)。单因素分析显示,宫颈癌淋巴结转移的相关因素有治疗前血清SCC-Ag水平、临床分期、宫颈管及宫颈阴道部浸润深度、宫旁韧带侵犯;SCC-Ag超过4μg/L时,淋巴结转移的风险增加4.2倍(P<0.001,OR=4.212)。多因素分析表明,临床分期和宫颈管肌层浸润深度是淋巴结转移最主要的高危因素。淋巴结转移规律分析结果显示,转移淋巴结主要分布在闭孔及闭孔窝区(48.0%);60.0%转移病例存在多组淋巴结转移,并出现跳跃式转移现象。淋巴结转移与宫颈深肌层侵犯、宫旁浸润之间关系密切,72.0%的淋巴结转移者同时存宫颈深肌层浸润,90.9%的宫旁韧带浸润者出现淋巴结转移。预后分析结果显示,术后补充放疗者的5年生存率较未作放疗者高(89.1%vs45.5%,P=0.012)。结论:治疗前血清SCC-Ag>4μg/L、宫颈阴道部深肌层浸润、宫旁韧带受侵,特别是临床分期晚、宫颈管深肌层浸润时,宫颈癌淋巴结转移的风险提高。术前评估淋巴结转移风险高的病例,应行标准的宫颈癌根治术,以保证系统的淋巴结清扫及足够的宫旁切除范围。对病理证实有盆腔淋巴结转移的患者,术后补充放疗可改善预后。     

Cancer of the penis. Prognosis and treatment plans

Sixty-one patients with clinical low-stage (Jackson Stage I) and 22 patients with clinical high-stage (Jackson Stage II or III or T3-4N0-1M0) carcinoma of the penis who were seen between 1952 and 1979 and followed for at least 3 years or until death were reviewed. The majority of patients with Stage I cancer were treated with partial penectomy, either with or without ilioinguinal lymphadenectomy. The remainder of patients with these early small lesions were treated with local excision or circumcision. Forty-one of the patients with this early penile cancer (Jackson Stage I or Tcis, T1N0M0 or T2N0M0) survived at least 3 years and were considered cured. The other 20 patients died of cancer (12 cases) or unrelated disease (8 cases). If the patients who died of other diseases are excluded, the corrected 5-year survival rate was 77%. Treatment failure was primarily due to metachronous inguinal metastases after initial treatment of the primary tumor and failure of response of metastatic disease to salvage treatment. Four factors probably were associated with a poor prognosis: large primary tumor, moderately to poorly differentiated cancer, younger age at onset, and inadequate initial treatment. In advanced (Jackson Stages II and III) disease, treatment by partial or total penectomy alone or in combination with radiation to inguinal nodes after penectomy produced 3-year or longer survival in only 2 of 9 patients, whereas treatment by early extended excision of both the primary lesion and the ilioinguinal lymph nodes produced 3-year or longer survival in 11 of 13 patients. The results suggest that local excision is appropriate only for carcinoma in situ. Partial penectomy and monthly follow-up for at least 1 year is appropriate for patients with small, well-differentiated primary tumors. Patients who have large or moderately to poorly differentiated primary tumors probably should undergo partial or total penectomy and immediate ilioinguinal lymphadenectomy.     

Lymphatic and vascular embolizations are independent predictive variables of inguinal lymph node involvement in patients with squamous cell carcinoma of the penis: Gruppo Uro-Oncologico del Nord Est (Northeast Uro-Oncological Group) Penile Cancer data base data

BACKGROUND: The objective of the current study was to identify independent clinical and pathologic variables that were predictive of lymph node involvement in patients with squamous cell carcinoma of the penis in a multicenter series with the intent to select patients who were suitable to undergo immediate inguinal lymphadenectomy. METHODS: Data were analyzed from 175 patients who underwent surgery for penile carcinoma in 11 urologic centers participating in the Gruppo Uro-Oncologico del Nord-Est (Northeast Uro-Oncological Group) Penile Cancer Data Base. Pathologically positive lymph nodes were defined as the presence of histologically confirmed lymph node metastasis in patients who underwent either immediate or delayed inguinal and/or pelvic lymphadenectomy. Patients who had clinically positive lymph nodes with cytologically positive fine-needle aspiration results and who had not undergone lymphadenectomy were censored. RESULTS: Overall, lymph-node involvement was observed in 71 of 175 patients (40.6%) included in the analyses. After analyzing the whole group of patients, the following variables were identified as independent predictors of pathologic lymph node metastasis: clinical lymph node status, pathologic stage of the primary tumor, venous and lymphatic embolizations, and histologic grade. In the subgroup of patients with clinically negative lymph nodes, tumor thickness, histologic grade, lymphatic and venous embolizations, infiltration of both corpus spongiosum and urethra, and pathologic stage of the primary tumor (according to the 1997 TNM classification system) were predictive of lymph node involvement on univariate analysis. The generated logistic regression model showed that venous and/or lymphatic embolizations and infiltration of the corpus spongiosum and/or urethra were independent predictors of pathologic lymph node metastasis in patients with clinically negative lymph nodes. CONCLUSIONS: Venous and/or lymphatic embolizations played relevant roles as predictors of pathologic lymph node involvement in patients with penile neoplasia and should be considered important parameters in determining which patients with clinically negative lymph nodes should undergo immediate lymphadenectomy.     

Risk of prostate carcinoma death in patients with lymph node metastasis

BACKGROUND: The presence of lymph node metastasis is a poor prognostic sign for patients with prostate carcinoma. Results of published reports on survival among patients with lymph node metastasis are difficult to assess because of treatment selections. The extent to which lymph node status will have an impact on a patient's survival is uncertain. METHODS: The authors analyzed 3463 consecutive Mayo Clinic patients who underwent radical prostatectomy and bilateral pelvic lymphadenectomy for prostate carcinoma between 1987 and 1993. Of these patients, 322 had lymph node metastasis at the time of surgery, and 297 lymph node positive patients also received adjuvant hormonal therapy within 90 days of surgery. The progression free rate and the cancer specific survival rate were used as outcome endpoints in univariate and multivariate Cox proportional hazards models. The median follow-up was 6.3 years. Progression was defined by elevation of serum prostate specific antigen (PSA) > or = 0.4 ng/mL after surgery, development of local recurrence, or distant metastasis documented by biopsy or radiographic examination. RESULTS: The 5-year and 10-year progression free survival rates (+/- standard error [SE]) for patients with lymph node metastasis were 74% +/- 2% and 64% +/- 3%, respectively, compared with 77% +/- 1% and 59% +/- 2%, respectively, for patients without lymph node metastasis. The 5-year and 10-year cancer specific survival rates were 94% +/- 1% and 83% +/- 4%, respectively, compared with 99% +/- 0.1% and 97% +/- 0.5%, respectively, for patients without lymph node metastasis. Among patients with a single lymph node metastasis, the 5-year and 10-year cancer specific survival rates were 99% +/- 1% and 94% +/- 3%, respectively. After adjustment for extraprostatic extension, seminal vesicle invasion, Gleason grade, surgical margins, DNA ploidy, preoperative serum PSA concentration, and adjuvant therapy, the hazard ratio for death from prostate carcinoma among patients with a single lymph node metastasis compared with patients who were without lymph node metastasis was 1.5 (95% confidence interval, 0.5-5.0; P = 0.478), whereas the hazard ratio for death from prostate carcinoma was 6.1 (95% confidence interval, 1.9-19.6; P = 0.002) for those with two positive lymph nodes and 4.3 (95% confidence interval, 1.4-13.0; P = 0.009) for those with three or more positive lymph nodes. There was no significant difference in the progression free survival rate among patients with or without lymph node metastasis in multivariate analysis after controlling for all relevant variables, including treatments (hazard ratio,1.0; 95% CI, 0.7-1.3; P = 0.90). CONCLUSIONS: Patients with prostate carcinoma who have multiple regional lymph node metastases had increased risk of death from disease, whereas patients with single lymph node involvement appeared to have a more favorable prognosis after radical prostatectomy and immediate adjuvant hormonal therapy. Excellent local disease control was achieved by using combined surgery and adjuvant hormonal therapy in patients with positive lymph nodes.     

Carcinoma of the uterine cervix stage IB and IIA: results of postoperative irradiation in patients with microscopic infiltration in the parametrium and/or lymph node metastasis

One hundred and thirty-two patients received postoperative radiation therapy following radical hysterectomy and pelvic lymphadenectomy for carcinoma of the uterine cervix Stage IB and IIA. In 43 patients with negative lymph node the 5- and 10-year survival rate was 85%. The other 89 patients with positive lymph node had 5- and 10-year survival rates of 60% and 51%, respectively. Multifactorial analysis of prognostic factors in the group of patients with lymph node metastasis disclosed pathology, microscopic infiltration in the parametrium and vascular space invasion as independent prognostic factors, that is, the 5-year survival rates were: 66% for squamous cell carcinomas versus, 25% for adenocarcinomas (p value: 0.001), 76% negative parametrium versus 39% positive parametrium (p value: 0.008), 68% no vascular space invasion versus 43% if invasion was observed (p value: 0.04). Sites of failure in 37 recurrences out of 89 patients with lymph node metastasis were pelvic alone 9, distant metastases alone 15, and combined pelvic plus distant metastasis in 12 patients. In one patient the site of failure was unknown. These data warrant more intensive local and systemic treatment, particularly in patients with poor prognostic factors. In the whole group, severe complications were observed in 11 patients.     

Lymphadenectomy and adjuvant therapy in endometrial carcinoma: role of adjuvant chemotherapy

To evaluate the therapeutic benefit of lymphadenectomy and adjuvant therapy, in particular chemotherapy, we retrospectively analysed survival rates and patterns of recurrence of endometrioid adenocarcinoma in 106 patients who underwent surgery including retroperitoneal lymphadenectomy. Adjuvant chemotherapy was administered to 46 patients (42 received a platinum-based regimen) and pelvic irradiation to 12. The 5-year survival rate of 23 patients with lymph node metastasis was worse than that of patients without lymph node metastasis (60% vs 96%, P<0.0001). Recurrence was observed in 14 patients (10 patients with chemotherapy, two with irradiation, and two without adjuvant therapy); the first site of recurrence was in distant sites in 12 patients; recurrence in the pelvic sidewall or exclusively in lymph nodes was not observed. The 5-year survival rate of 18 patients with lymph node metastasis treated with chemotherapy, was 61% including all 14 with macroscopically positive nodes and all nine with paraaortic metastasis. Of seven patients with bulky positives nodes, three patients with bulky paraaortic nodes died of the disease, three of the four patients with bulky pelvic but without bulky paraaortic nodes had no recurrence. In summary, lymphadenectomy may afford a survival benefit via the debulking of macroscopically positive nodes, and the predominance of distant recurrences suggests that chemotherapy is a suitable choice as an adjuvant therapy in endometrial carcinoma after lymphadenectomy.     

直肠癌行侧方淋巴结清扫52例临床分析

目的探讨中下段直肠癌的侧方淋巴结转移情况。方法对1996年6月至2004年8月间行传统直肠癌根治术加盆腔侧方淋巴结清扫术的52例中下段直肠癌的临床资料进行回顾性分析。结果全组侧方淋巴结转移率9.62%(5/52)。有侧方淋巴结转移者多为浸润型和溃疡型,肿瘤较大占1/2肠周以上(直径>4 cm),肿瘤浸润全层并有局部外侵,分化差的低分化及黏液腺癌及年龄<50岁。结论应有选择性地对溃疡型或浸润型、肿瘤较大及分化差的中下段直肠癌患者行侧方淋巴结清扫术。     

子宫内膜癌淋巴取样术的临床意义

目的：探讨子宫内膜癌盆腔及腹主动脉旁淋巴取样的临床意义。方法：分析1995年1月～2002年12月本院手术治疗的311例子宫内膜癌患者,其中,197例行淋巴取样或淋巴清扫。手术方式根椐手术切除淋巴结情况分为二组。1）取样组,筋膜外全子宫双附件切除/次广泛子宫切除术＋盆腔/腹主动脉旁淋巴结取样术114例;2）清扫组,次广泛/广泛子宫切除术＋盆腔淋巴结清扫/腹主动脉旁淋巴结切除术83例。结果：取样组切除淋巴结中位组数5组,中位切除淋巴结15枚,淋巴结转移8例。清扫组切除淋巴结中位组数8组,中位切除淋巴结27枚,淋巴结转移6例。5年生存率分别为90.2%和90.9%。结论：子宫内膜癌淋巴取样术可准确了解淋巴结转移情况,适宜手术分期,并不影响生存率,是避免过度治疗的方法。     

Can we omit para-aorta lymph node dissection in endometrial cancer?

BACKGROUND: Patients with endometrial cancer can present with various complicating illnesses, including obesity, diabetes mellitus, hypertension and advanced aging. These patients are at high risk of severe post-operative complications. Thus, the question of whether or not to perform systemic pelvic and para-aortic lymphadenectomy remains controversial for all patients. It is reported that external iliac lymph nodes are the most commonly involved lymph nodes in endometrial cancer, and para-aortic lymph node (PAN) metastases spread via a route shared by the common iliac lymph nodes. The aim of this study was to evaluate the potential efficacy of omitting PAN dissection when metastasis of the common iliac and external iliac lymph nodes is negative. METHODS: Between January 1994 and June 2004, a total of 101 patients at Akita University Hospital who had undergone total hysterectomy and bilateral salpingo-oophorectomy, total pelvic lymphadenectomy and para-aortic lymphadenectomy to the level of the renal vein for endometrial cancer were enrolled in this study. RESULTS: Eleven patients in all were found to have metastasis for PANs. Among 13 patients with common and/or external iliac positive lymph nodes, 10 showed PAN metastasis. Of the 88 patients with negative lymph nodes, 87 showed no PAN metastasis. Based on these data, common and/or external iliac lymph nodes had 90.9% sensitivity (10/11) and 96.7% specificity (87/90) for detecting PAN metastasis. CONCLUSION: Para-aortic lymphadenectomy might be avoided by the negativity of such lymph nodes, thereby minimizing post-operative complications.