Surgery Overview

Lymphadenectomy is surgery to remove lymph nodes. A lymphadenectomy, also called lymph node dissection, may be done to examine certain lymph nodes for endometrial cancer cells. The removal and examination of the cancerous lymph nodes will determine the exact stage and grade of the cancer and may reduce the spread of the disease. The procedure can be done through an abdominal incision or by laparoscope.

A lymphadenectomy may be done:

• If cancer cells are found in certain lymph nodes that were removed in an earlier surgical procedure.
• As part of a hysterectomy if cancer has invaded the deep part of the muscle, the cancer is of higher grade, or your doctor suspects that cancer may spread to other parts of the body.

Lymphadenectomy usually is an extensive operation in which lymph nodes in different parts of the pelvis are removed. This is necessary because cancer can spread through the lymph system to other areas of the body.

What To Expect After Surgery

Lymphadenectomy usually is done under general anesthesia. The length of time required for recovery depends upon the extent of the procedure. If the procedure is done with a laparoscope rather than by open abdominal incision, recovery time may be shorter. However, most surgeons have more experience with open surgery than with laparoscopic surgery. Laparoscopic surgery may take longer than open surgery unless the surgeon is well-experienced with laparoscopic techniques.

Why It Is Done

Some doctors recommend that a lymphadenectomy be performed in all cases of endometrial cancer. Others believe that this procedure might not be necessary when the cancer is diagnosed at a very early stage and is found to be a slow-growing grade.¹ Lymphadenectomy may be necessary if:

• Cancer cells are found in selected lymph nodes that were removed in an earlier surgical procedure.
• Cancer cells are found in a lymph node at the time you are having surgery.
• Your pelvic lymph nodes are enlarged.
• Cancer cells are a higher grade (faster-growing).
• Cancer cells have grown into the muscle of the uterus, the cervix, or other areas of the pelvis.
• The cancer is large.

How Well It Works

Removal of lymph nodes helps to determine whether cancer is present and provides more accurate information about the extent and type of cancer cell growth. Removal of the cancerous lymph nodes may reduce the spread of cancer.

Risks

Risks of a lymphadenectomy include:

• Bleeding.
• Infection.
• Collection of lymph fluid in the pelvis (lymphocele).

What To Think About

Lymphadenectomy often is not done if earlier tests indicate that low-grade cancer is in a very early stage.

Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.

References

Citations

1. DuBeshter B, et al. (2003). Endometrial cancer: The potential role of cervical cytology in current surgical staging. Obstetrics and Gynecology, 101: 445–450.

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