Prediction of lymph node metastasis in patients with apparent early endometrial cancer
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Objective The purpose of this study is to investigate the incidence of lymph node metastasis in early endometrial cancer patientsand to evaluate preoperative clinicopathological factors predicting lymph node metastasis. Methods We identified 142 patients with endometrial cancer between January 2000 and February 2013. All patientsdemonstrated endometrioid adenocarcinoma with grade 1 or 2 on preoperative endometrial biopsy. Preoperativemagnetic resonance imaging showed that tumors were confined to the uterine corpus with superficial myometrialinvasion (less than 50%), and there were no lymph nodes enlargements. All patients had complete staging proceduresand were surgically staged according to the 2009 FIGO (International Federation of Gynecology and Obstetrics) stagingsystem. Clinical and pathological data were obtained from medical records and statistically analyzed. Results Of the 142 patients, 127 patients (89.4%) presented with stage 1A, 8 (5.6%) with stage IB, 3 (2.1%) with stage II, and4 (2.8%) with stage III disease. Three patients (2.1%) had lymph node metastasis—2 IIIC1 and 1 IIIC2 disease. Age,preoperative tumor grade, and myometrial invasion less than 50% on preoperative MRI were not associated withlymph node metastasis. A high preoperative serum CA-125 level (>35 IU/mL) was a statistically significant factor forpredicting lymph node metastasis on univariate and multivariate analyses. Lymph node metastasis was only found inpatients with preoperative grade 2 tumors or a high serum CA-125 level. Conclusion Preoperative tumor grade and serum CA-125 level can predict lymph node metastasis in apparent early endometrialcancer patients.
Abstract
Objective The purpose of this study is to investigate the incidence of lymph node metastasis in early endometrial cancer patientsand to evaluate preoperative clinicopathological factors predicting lymph node metastasis. Methods We identified 142 patients with endometrial cancer between January 2000 and February 2013. All patientsdemonstrated endometrioid adenocarcinoma with grade 1 or 2 on preoperative endometrial biopsy. Preoperativemagnetic resonance imaging showed that tumors were confined to the uterine corpus with superficial myometrialinvasion (less than 50%), and there were no lymph nodes enlargements. All patients had complete staging proceduresand were surgically staged according to the 2009 FIGO (International Federation of Gynecology and Obstetrics) stagingsystem. Clinical and pathological data were obtained from medical records and statistically analyzed. Results Of the 142 patients, 127 patients (89.4%) presented with stage 1A, 8 (5.6%) with stage IB, 3 (2.1%) with stage II, and4 (2.8%) with stage III disease. Three patients (2.1%) had lymph node metastasis—2 IIIC1 and 1 IIIC2 disease. Age,preoperative tumor grade, and myometrial invasion less than 50% on preoperative MRI were not associated withlymph node metastasis. A high preoperative serum CA-125 level (>35 IU/mL) was a statistically significant factor forpredicting lymph node metastasis on univariate and multivariate analyses. Lymph node metastasis was only found inpatients with preoperative grade 2 tumors or a high serum CA-125 level. Conclusion Preoperative tumor grade and serum CA-125 level can predict lymph node metastasis in apparent early endometrialcancer patients.
참고문헌 (20)
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