A Cochrane review included 2 studies with a total of 1945 women with mainly stage I endometrial carcinoma. No significant difference was found in 3-4 years follow-up between women who received lymphadenectomy and those who received no lymphadenectomy in overall and recurrence-free survival (pooled HR 1.07, 95% CI 0.81 to 1.43 and HR 1.23, 95% CI 0.96 to 1.58 respectively; 2 trials, n=1851). There was no statistically significant difference in risk of direct surgical morbidity between the groups. However, risk of adverse events was significantly higher in women who received lymphadenectomy (lymphoedema and lymphocyst formation RR 8.39, 95% CI 4.06 to 17.33; n=1922). Neither trial reported quality of life.
Comment: The quality of evidence is downgraded by indirectness (short follow-up).