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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 10/2009

01-10-2009 | Gynecologic Oncology

The Risk of Lymph Node Metastasis Based on Myometrial Invasion and Tumor Grade in Endometrioid Uterine Cancers: A Multicenter, Retrospective Korean Study

Authors: Kwang-Beom Lee, MD, PhD, Kyung-Do Ki, MD, PhD, Jong-Min Lee, MD, PhD, Jae-Kwan Lee, MD, PhD, Jae Weon Kim, MD, PhD, Chi-Heum Cho, MD, PhD, Seok-Mo Kim, MD, PhD, Sang-Yoon Park, MD, PhD, Dae-Hoon Jeong, MD, PhD, Ki-Tae Kim, MD, PhD

Published in: Annals of Surgical Oncology | Issue 10/2009

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Abstract

Background

Knowledge of the risk factors for lymph node metastasis (LNM) is necessary to treat patients with endometrioid uterine cancer to optimize and further individualize treatment. This study was designed to determine the risk of LNM based on myometrial invasion and tumor grade in endometrioid uterine cancer.

Methods

The authors retrospectively reviewed the medical records and pathological findings of 834 patients who underwent surgical staging, including pelvic lymphadenectomy with or without para-aortic lymphadenectomy, for endometrioid uterine cancer from 2002 to 2008 in Korea.

Results

Of the 834 patients with endometrioid uterine cancer, 107 (12.8%) patients had LNM. Sixty-one (57%) patients had only pelvic LNM, 39 (36.4%) had pelvic and para-aortic LNM, and 7 (6.6%) had isolated para-aortic LNM. Tumor grade, myometrial invasion, tumor diameter, cervical extension, lymphovascular space invasion, and adnexal involvement were found to be significant predictors of LNM. Of 215 patients with no myometrial invasion and tumor grade I/II, only 1 (0.47%) had LNM. However, in other patients, the risk of LNM was significant and at least > 3.5%. Furthermore, the risk of LNM was found to be well correlated with increases in myometrial invasion and tumor grade based on subgroup analyses, when patients with no myometrial invasion and tumor grade I/II were used as a reference group (p < 0.0001).

Conclusions

Patients with endometrioid uterine cancers with no myometrial invasion and tumor grade I/II might have minimal risk of LNM, whereas others might require complete pelvic and para-aortic lymphadenectomy for surgical staging.
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Metadata
Title
The Risk of Lymph Node Metastasis Based on Myometrial Invasion and Tumor Grade in Endometrioid Uterine Cancers: A Multicenter, Retrospective Korean Study
Authors
Kwang-Beom Lee, MD, PhD
Kyung-Do Ki, MD, PhD
Jong-Min Lee, MD, PhD
Jae-Kwan Lee, MD, PhD
Jae Weon Kim, MD, PhD
Chi-Heum Cho, MD, PhD
Seok-Mo Kim, MD, PhD
Sang-Yoon Park, MD, PhD
Dae-Hoon Jeong, MD, PhD
Ki-Tae Kim, MD, PhD
Publication date
01-10-2009
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 10/2009
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-009-0535-0

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