Changing Trends in Lymphadenectomy for XXXX of the Endometrium.

@entity1 @entity1204 @entity5 @entity3 @entity4348
OBJECTIVE: To describe trends in the use of lymphadenectomy for @entity4348 of the endometrium between 1998 and 2012. METHODS: A time-trend analysis was conducted using a population-based @entity5 registry covering 28% of the population of the United States. To quantify differences over the study period time, the frequency of lymphadenectomy and nodal @entity3 among @entity1 who underwent surgical treatment of @entity1204 was compared among consecutive 3- to 4-year periods. Biannual frequency of lymphadenectomy was modeled with Joinpoint regression to identify when potential changes in trends occurred and calculate annual percentage change. RESULTS: A total of 74,365 @entity1 who underwent surgery between 1998 and 2012 were analyzed. Frequency of lymphadenectomy increased by 4.2% annually (95% confidence interval [CI] 3.7-4.6) from 1998 to 2007, after which the frequency declined by 1.6% per year (95% CI 0.9-2.2). Between 1998-2000 and 2007-2009, the frequency of lymphadenectomy rose from 48.7% to 65.5% (risk difference 16.8%, 95% CI 15.4-18.1), the proportion of @entity1 found to have nodal @entity3 increased by 1.1% (95% CI 0.4-1.7), and the frequency of negative lymphadenectomy increased by 15.7% (95% CI 14.3-17.1). The decline in frequency of lymphadenectomy after 2007 was associated a 3.1% (95% CI 2.1-4.1) decline in the rate of negative lymphadenectomy, but no change in the proportion of @entity1 found to have nodal @entity3 (P=.17). CONCLUSION: The frequency of lymphadenectomy in the surgical treatment of @entity1204 increased by 4.2% annually from 1998 to 2007 and decreased by 1.6% annually from 2007 to 2012. LEVEL OF EVIDENCE: II.
