Lymph Node Count Does Not Predict Recurrence or Survival in Surgically Treated Endometrial Cancer: A 15-Year Single-Center Study

Abstract

Background: This study aimed to identify prognostic determinants in patients who underwent surgical management for endometrial carcinoma at a tertiary-level gynecological oncology center.Materials and Methods: A retrospective cohort analysis was performed, including patients who underwent primary surgical treatment for endometrial carcinoma between 2010 and 2025. Individuals with synchronous malignancies, incomplete follow-up data, prior neoadjuvant chemotherapy, or surgery performed at external institutions were excluded.Results: A total of 436 patients met the inclusion criteria. During follow-up, disease recurrence was observed in 58 patients, while 76 patients died. The overall survival (OS) rate was 82.6%, and recurrence-free survival (RFS) was 86.7%. Patients were stratified by the number of excised lymph nodes: <= 10 versus >10. RFS was 88.7% in the <= 10 group and OS was 84.6% in the >10 group (p = 0.432). No significant difference in recurrence rates was identified between the two groups (p = 0.201). While the extent of lymphadenectomy did not influence OS or RFS, lymph node metastasis was significantly associated with recurrence risk (odds ratios: 4.360, 95% confidence interval: 2.160-8.803, p < 0.001).Conclusions: The total number of lymph nodes removed did not significantly impact survival or recurrence rates. These findings highlight the growing importance of incorporating additional prognostic variables-such as molecular classifiers and lymphovascular space invasion-into individualized treatment planning and risk stratification in endometrial carcinoma.