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Table 5 Recommendation for lymphadenectomy in endometrial cancer in clinical practice

From: Whether intermediate-risk stage 1A, grade 1/2, endometrioid endometrial cancer patients with lesions larger than 2 cm warrant lymph node dissection?



Intermediate risk

High risk

Lymphadenectomy required for low-risk patients

FIGO (2015) [16]

Grade 1 or grade2, < 1/2 myometrial invasion


grade 3,>50% of myometrial invasion,lymphovascular space invasion,non-endometrioid histology (serous, clear cell, undifferentiated, small cell, anaplastic, etc). cervical stromal involvement

systematic lymphadenectomy is not recommended,suspicious lymph nodes sampling is recommended

ESMO(2016) [15]

grade 1 or 2 and superficial myometrial invasion <50%

grade 1 or 2 deep myometrial invasion >50% or grade 3 superficial myometrial invasion <50%

grade 3 with deep myometrial invasion >50%

systematic lymphadenectomy is not recommended for LR patients (it can be considered for IR patients)

NCCN(NCCN Guidelines®, uterine neoplasms, version 2. 2016)

less than 50% myometrium invasion, tumor diameter < 2 cm, well or moderate differentiated histology


deeply invasive lesions, high-grade histology, and tumors of serous carcinoma, clear cell carcinoma, or carcinosarcoma features

systematic lymphadenectomy is not necessary.Excision suspious or enlarged lymph nodes is recommended