Predicting Pelvic Lymph Node Metastasis in Endometrial Carcinoma

Kamura, Toshiharu; Yahata, Hideaki; Shigematsu, Toshiyuki; Ogawa, Shinji; Amada, Satoshi; Kaku, Tsunehisa; Nakano, Hitoo

doi:10.1006/gyno.1998.5288

Cited by 52 publications

(39 citation statements)

References 14 publications

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“…17 Kamura et al showed that EC with PLN metastasis had a significantly greater diameter than those without PLN metastasis, and a logistic regression analysis re-vealed deep myometrial invasion (>1/2) and primary tumor diameter more than 50 mm to be independently correlated with pelvic lymph node metastasis. 3 On the other hand, Takeshima et al reported that PLN metastasis was observed in four of 100 EC patients with no myometrial invasion, in which tumor size for all four patients was less than 2 cm. 18 In our study, a significant correlation was found between the depth of myometrial invasion and the presence of metastatic lymph nodes.…”

Section: Lymph Node Numbermentioning

confidence: 95%

See 1 more Smart Citation

The Predictability of Lymph Node Metastasis in Patients with Endometrial Cancer

Yildiz¹,

Özcan²,

Yetimalar³

et al. 2013

Turkiye Klinikleri J Med Sci

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A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : The aim of this study was to predict lymphatic involvement in endometrial cancer patients using clinicopathological variables in patients treated with surgical staging. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : A retrospective chart review was performed in 147 women with pathologically proven endometrial carcinoma (EC) who were treated between January 2006 and January 2011. Surgically staged 125 patients were included in this study. We choose the patients who underwent surgical staging including washing cytology, total abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymph node (PLN) and para-aortic lymph node (PALN) dissection. The depth of tumor invasion, cervical extension and the tumor diameter were intraoperatively assessed via fresh frozen sections of the removed uterus. Demographic data, preoperative and postoperative variables were evaluated for association with any lymph node (LN) metastasis. R Re es su ul lt ts s: : The medical records of 125 patients were eligible for analysis. The presence of LN metastasis was significantly associated with the patient's age (p=0.016) and but not with body mass index (p=0.288). Preoperative findings such as atypical cells in smear (p=0.001), computed tomography (CT) features of malignancy (p=0.014), ultrasonographic findings related with malignancy (p=0.011), presence of myometrial invasion on CT (p=0.011), preoperative serum CA125 level (p<0.001), preoperative serum CA15-3 level (p<0.001), clinical stage (p<0.001), and histologic grade (p=0.001) were significantly associated with LN metastasis. Postoperative findings which were significantly associated with LN metastasis were grade of differentiation, lymphovascular invasion, depth of myometrial invasion, dissemination to omentum or appendix, and positive peritoneal cytology. The mean number of all lymph nodes removed during operation was 38.9±14.194 (range 9-81), PLN number was 32±11.747 (range 9-75) and PALN number was 7±5.123 (range 0-20). Nodal metastasis was shown in 24 patients (19.2%). Isolated PLN metastasis was shown in 9 patients (37%), isolated PALN metastasis in one (4%); both PLN and PALN metastasis was shown in 14 patients (59%). The most frequently affected LN area was the region of the left external iliac artery, with a ratio of 14%.The p value was set at <0.05 for statistical significance. C Co on nc cl lu us si io on n: : Lymphatic involvement in EC should be carefully evaluated using clinicopathologic variables of patients. Demographic characteristics, preoperative and postoperative surgical-pathologic factors determine the lymph node metastasis of the tumor. K Ke ey y W Wo or rd ds s: : Endometrial neoplasms; lymph node excision; lymph nodes Ö ÖZ ZE ET T A Am ma aç ç: : Bu çalışmanın amacı, cerrahi evreleme uygulanan endometrial kanserli hastalarda klinik ve patolojik değişkenleri kullanarak lenf nodu (LN) tutulumunun öngörülebilmesidir. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Ocak 2006 ile O...

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Section: Lymph Node Numbermentioning

confidence: 95%

“…1,2 Many different prognostic factors were reported to be related to lymphatic involvement. 3,4 Although the main purpose of these series was to formulate lymphatic dissection by using prognostic factors, the results and conclusions of the mentioned studies have been rather inconsistent.…”

Section: Gynecology and Obstetricsmentioning

confidence: 99%

The Predictability of Lymph Node Metastasis in Patients with Endometrial Cancer

Yildiz¹,

Özcan²,

Yetimalar³

et al. 2013

Turkiye Klinikleri J Med Sci

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“…Several authors have proposed different scores in order to predict LN metastasis [45][46][47][48][49][50][51][52][53] (table 2).…”

Section: Scores To Predict Ln Metastasismentioning

confidence: 99%

Staging for endometrial cancer: The controversy around lymphadenectomy – Can this be resolved?

Koskas¹,

Rouzier²,

Amant³

2015

Best Practice & Research Clinical Obstetrics & Gynaecol

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Endometrial cancer remains the most common malignancy of the female genital tract. Lymph node metastasis is one of the most important prognostic factors and stratification into pelvic lymph node invasion (stage IIIC1) and para-aortic lymph node invasion (stage IIIC2) improved the predictive value of the 2009 FIGO classification.Radiological examination such as magnetic resonance imaging and positron emission tomography-computed tomography do not have good enough sensitivity to avoid lymphadenectomy for the assessment of lymph node invasion. Prediction scores are becoming more and more valuable to exclude lymph node metastasis in low risk groups and biomarkers could help to identify patients with high risk lymph node metastatic probability.The therapeutic role of lymph node dissection remains debated. Several endpoints can be considered to evaluate the opportunity of lymphadenectomy in endometrial cancer.Firstly, we compare survival according to the realization, the extent and the numbers of nodes removed during lymphadenectomy. Secondly, we assess the opportunity of lymphadenectomy in order to tailor adjuvant treatment modalities. Thirdly, we analyze the surgical complication rate after pelvic lymphadenectomy.

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“…In most patients the disease is confined to the uterine corpus. Lymph node metastasis is reportedly one of the most potent prognostic factors [2] and was found to correlate with many histopathologic prognostic factors, particularly myometrial invasion, cervical invasion, tumor diameter, adnexal metastasis and histological grade [3]. Unfortunately, the majority of these factors can only be accurately determined after surgery, so their preoperative predictive value is limited.…”

Section: Introductionmentioning

confidence: 99%

Serum CA 125 levels and lymph node metastasis in patients with endometrial cancer

Takač

Gorišek

2006

Wien Klin Wochenschr

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The aim of this study was to evaluate the correlation of preoperative serum CA 125 levels and lymph node metastasis in patients with endometrial cancer. Preoperative levels of serum CA 125 were determined in 64 patients with endometrial cancer treated with total abdominal hysterectomy with a lymph node dissection as initial therapy. Lymph node status, determined by histopathology, was correlated with both normal and elevated CA 125 levels, determined preoperatively. A serum CA 125 level of >30 IU/ml was considered elevated. There were five patients (7.8%) with pelvic or paraaortic lymph node metastases and 59 patients (92.2%) without nodal metastases. In all five patients with lymph node metastases, serum CA 125 was within normal limits. Preoperative serum CA 125 levels were above normal in eight lymph node-negative patients. In the remaining group of 51 node-negative patients, serum CA 125 levels were within normal limits. Among the five lymph node-positive patients, four had endometrioid and one had serous papillary cancer. One patient had histologic grade 2 tumor and four patients had histologic grade 3. Preoperative serum CA 125 levels do not offer any information for predicting lymph node metastasis in patients with endometrial cancer.

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Predicting Pelvic Lymph Node Metastasis in Endometrial Carcinoma

Cited by 52 publications

References 14 publications

The Predictability of Lymph Node Metastasis in Patients with Endometrial Cancer

The Predictability of Lymph Node Metastasis in Patients with Endometrial Cancer

Staging for endometrial cancer: The controversy around lymphadenectomy – Can this be resolved?

Serum CA 125 levels and lymph node metastasis in patients with endometrial cancer

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