A study of the treatment of cancer of the womb (ASTEC - Surgery)

Cancer type:

Womb (uterine or endometrial) cancer

Status:

Results

Phase:

Phase 3

This trial was looking at the treatment of womb cancer. There were 2 parts to the trial. It was looking into

Surgery to remove lymph nodes
Radiotherapy after surgery

This information is about the surgical part of the trial. We also have information about the radiotherapy part of the trial.

If it is diagnosed early, womb cancer can be cured by having surgery to remove the womb. But there is a risk that the cancer could come back. In this trial, researchers wanted to see if removing some lymph nodes Open a glossary item from either side of the womb, as well as the womb itself, reduced the risk of the cancer coming back. An operation to remove lymph nodes is called a lymphadenectomy.

The aim of this trial was to find out if women who had a hysterectomy with removal of lymph nodes for womb cancer lived longer than women who had just a hysterectomy.

Some of the women who took part, also took part in the radiotherapy part of the trial.

Summary of results

The trial team found that women who had lymph nodes removed did not live any longer than women who had standard surgery to remove just the womb.

The trial recruited 1,408 women with womb cancer that was stage 1 according to tests and scans they had before surgery.

Half the women had surgery to remove the womb, fallopian tubes and ovaries (hysterectomy and BSO )
Half had a hysterectomy and BSO, but also had lymph nodes removed (lymphadenectomy )

The number of women who had a side effect called lymphoedema after surgery was

2 in the standard surgery group
24 in the lymphadenectomy group

The trial team monitored the women taking part for an average of just over 3 years. They found that the number of women who were living without having had a recurrence of cancer was about the same in both groups.

The researchers found that removing lymph nodes as part of treatment did not help women in this trial. And it caused more problems with lymphoedema. So, the trial team came to the conclusion that removing lymph nodes should not become part of standard treatment for stage 1 womb cancer.

Doctors will still need to remove some lymph nodes if they look as though they may contain cancer cells. This helps them make decisions about further treatment after surgery.

We have based this summary on information from the team who ran the trial. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item ) and published in a medical journal. The figures we quote above were provided by the trial team. We have not analysed the data ourselves.