SELECTIVE PELVIC LYMPHADENECTOMY IN EARLY-STAGE ENDOMETRIAL CANCER: EVIDENCE FROM MRC ASTEC, PANICI P TRIALS, AN INSTITUTIONAL CASE SERIES

The management of early-stage endometrial cancer has evolved significantly with advancements in surgical techniques and adjuvant therapies. The Multicentre Randomised Controlled trial of Surgery for Endometrial Cancer (MRC ASTEC) and the Panici P trial have been pivotal in shaping contemporary treatment guidelines (1, 2). Both t r i a l s ex a m i n ed t h e ro l e o f s y s t e m a ti c pe l v i c lymphadenectomy in patients diagnosed with early-stage endometr ial cancer, specifically FIGO Stage 1 on preoperative imaging.The debate surrounding the necessity of pelvic lymphadenectomy in this subset of patients persists, with proponents advocating for its therapeutic and diagnostic benefits, while critics argue for its potential overtreatment and associated morbidities (3, 4). In this case series conducted in Department of Surgical Oncology,AIIMS Patna, we present three cases where patients diagnosed with earlystage endometrial cancer based on preoperative imaging (FIGO 1 staging) did not undergo pelvic lymphadenectomy. We aim to evaluate the clinical outcomes and validate the safety and efficacy of omitting pelvic lymphadenectomy in carefully selected cases of early-stage endometrial cancer.