A novel multivariable prediction model for lymphatic dissemination in endometrioid endometrial cancer: The lymph node Metastasis Risk Index

Meydanlı, Mehmet Mutlu; Aslan, Koray; Öz, Murat; Muftuoglu, Kamil Hakan; Yalçın, İbrahim; Engin-Üstün, Yaprak

doi:10.1016/j.ejogrb.2019.07.015

Cited by 11 publications

(26 citation statements)

References 39 publications

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“…In order to facilitate clinical application, continuous variables were converted into classified variables; this practice was in accordance with clinically recognized criteria, and the results of previous studies. 7,[16][17][18][19] To prevent the exclusion of meaningful variables by univariate analysis, we set the test level for univariate analysis at α = 0.1 20 ; all other tests were set to α = 0.05.…”

Section: Discussionmentioning

confidence: 99%

“…LNM is the main pathway for the metastasis of EC, and also an independent prognostic factor. 3,16 As a consequence, there is significant interest in this pathway from a clinical and research point-of-view. However, there has been significant debate with regards to the necessity for systematic lymphadenectomy in patients with early-stage EC.…”

Section: Discussionmentioning

confidence: 99%

“…However, there has been significant debate with regards to the necessity for systematic lymphadenectomy in patients with early-stage EC. 16,21 Some studies have shown that systematic lymph node dissection has no benefit with regards to improving the prognosis of patients with early-stage EC. Furthermore, this type of surgery is associated with a surgical complication rate of 15-20%, thus affecting patients' quality of life.…”

Section: Discussionmentioning

confidence: 99%

“…This is due to the differing opinions of various organizations, and contradictory conclusions in the published literature. 16,18,23,26 Therefore, there is an urgent need to construct an efficient system with which to evaluate the risk of LNM, and be able to stratify risk for patients with early-stage EC. This would provide guidance for the clinical selection of lymphadenectomy.…”

Section: Discussionmentioning

confidence: 99%

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Establishment and evaluation of a risk‐scoring system for lymph node metastasis in early‐stage endometrial carcinoma: Achieving preoperative risk stratification

Zhang

Zhao

Chen

et al. 2020

J of Obstet and Gynaecol

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Aim: To establish a risk-scoring system for lymph node metastasis (LNM) of early-stage endometrial carcinoma (EC), and to stratify the preoperative risk of LNM. Methods: We retrospectively analyzed the clinical data of 507 patients diagnosed with the early-stage EC (i.e., confined to the uterine corpus). We determined the risk factors for LNM by logistic regression analysis; then constructed a simple logistic scoring system, and an additive scoring system based on the regression coefficient (β), and odds ratio, of each variable, respectively. Results: The overall rate of LNM was 9.1% (46/507). Multivariate analysis showed that preoperative serum cancer antigen 125 (CA125) ≥35 U/mL, histopathology of grade 3 and/or type II, depth of myometrial invasion ≥1/2 and positive immunostaining for Ki-67 ≥50%, were independent risk factors for LNM (P < 0.05). The simple logistic and additive scoring systems exhibited good predictive ability (area under the curve [AUC] >0.8). Based on the additive scoring system, the risk of LNM in patients with early-stage EC was classified into three groups: a low-risk group (total score: <5), an intermediate-risk group (total score: 5-10) and a high-risk group (total score: >10). The incidence of LNM differed significantly across these three groups (P < 0.05). Conclusion: The risk-scoring system constructed in this study can effectively predict the risk of LNM in patients with early-stage EC, achieve preoperative risk stratification and provide a reference guideline for the use of lymphadenectomy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Establishment and evaluation of a risk‐scoring system for lymph node metastasis in early‐stage endometrial carcinoma: Achieving preoperative risk stratification

Zhang

Zhao

Chen

et al. 2020

J of Obstet and Gynaecol

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“…Five-year overall survival in stage I endometrioid endometrial cancer decreases with increasing grade (grade 1: 93%, grade 2: 90% and grade 3: 79%) 7 . Tumor size and tumor extension are predictive of lymph node metastases 5,6,[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] , recurrence and survival [6][7][8]11 .…”

Section: List Of Abbreviationsmentioning

confidence: 99%

Ultrasound‐based risk model for preoperative prediction of lymph‐node metastases in women with endometrial cancer: model‐development study

Eriksson

Epstein

Testa

et al. 2020

Ultrasound in Obstet & Gyne

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Background: Endometrial cancer is the most common gynecological cancer in the industrialized world, constituting 4.5% of all cancer in Swedish women. Standard surgery is hysterectomy and bilateral salpingo-oophorectomy, with or without lymphadenectomy, depending on the estimated risk of lymph node metastases. Adjuvant therapy is given, depending on the estimated risk of adverse outcome. Numerous risk stratification systems guide the choice on lymphadenectomy, but none is associated with a high accuracy. Lymph node metastases are found in 11-22% of women. If they could be accurately predicted, many lymphadenectomies could be avoided. The aim of this thesis was to improve preoperative risk assessment in women with endometrial cancer, with regard to predicting deep (≥ 50%) myometrial invasion (MI), cervical stromal invasion (CSI), lymph node metastases and recurrence or progression.

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Importance of pre-operative ultrasound examination and pathological tumour evaluation in the management of women with endometrial cancer

Sobočan

Ogrizek

Ledinek

et al. 2021

European Journal of Obstetrics & Gynecology and Reproductiv

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A novel multivariable prediction model for lymphatic dissemination in endometrioid endometrial cancer: The lymph node Metastasis Risk Index

Cited by 11 publications

References 39 publications

Establishment and evaluation of a risk‐scoring system for lymph node metastasis in early‐stage endometrial carcinoma: Achieving preoperative risk stratification

Establishment and evaluation of a risk‐scoring system for lymph node metastasis in early‐stage endometrial carcinoma: Achieving preoperative risk stratification

Ultrasound‐based risk model for preoperative prediction of lymph‐node metastases in women with endometrial cancer: model‐development study

Importance of pre-operative ultrasound examination and pathological tumour evaluation in the management of women with endometrial cancer

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