Obstet Gynecol Sci.  2015 Sep;58(5):385-390. 10.5468/ogs.2015.58.5.385.

Prediction of lymph node metastasis in patients with apparent early endometrial cancer

• Son JH
• Kong TW
• Kim SH
• Paek J
• Chang SJ
• Lee EJ
• Ryu HS

• KMID: 2058462
• DOI: http://doi.org/10.5468/ogs.2015.58.5.385

Abstract

OBJECTIVE
The purpose of this study is to investigate the incidence of lymph node metastasis in early endometrial cancer patients and to evaluate preoperative clinicopathological factors predicting lymph node metastasis.
METHODS
We identified 142 patients with endometrial cancer between January 2000 and February 2013. All patients demonstrated endometrioid adenocarcinoma with grade 1 or 2 on preoperative endometrial biopsy. Preoperative magnetic resonance imaging showed that tumors were confined to the uterine corpus with superficial myometrial invasion (less than 50%), and there were no lymph nodes enlargements. All patients had complete staging procedures and were surgically staged according to the 2009 FIGO (International Federation of Gynecology and Obstetrics) staging system. 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, and 4 (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 with lymph node metastasis. A high preoperative serum CA-125 level (>35 IU/mL) was a statistically significant factor for predicting lymph node metastasis on univariate and multivariate analyses. Lymph node metastasis was only found in patients 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 endometrial cancer patients.

Keyword

CA-125; Endometrial neoplasms; Lymph node; Metastasis; Tumor grade

MeSH Terms

Biopsy
Carcinoma, Endometrioid
Endometrial Neoplasms*
Female
Gynecology
Humans
Incidence
Lymph Nodes*
Magnetic Resonance Imaging
Medical Records
Multivariate Analysis
Neoplasm Metastasis*

Figure

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  Fig. 1 Inclusion criteria. MRI, magnetic resonance imaging; Preop, preoperative; LN, lymph node.

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