Distinct Lymphatic Spread of Endometrial Carcinoma in Comparison with Cervical Carcinoma
10.3969/j.issn.1000-8179.2009.21.005
- VernacularTitle:子宫内膜癌与宫颈癌淋巴结转移分布的比较
- Author:
Yanyan FAN
;
Yan FU
;
Zanhui JIA
;
Guiying ZHENG
- Publication Type:Journal Article
- Keywords:
Endometrial carcinoma;
Lymphatic metastases;
Pelvic lymph node;
Aortic lymph node;
Cervical carcinoma
- From:
Chinese Journal of Clinical Oncology
2009;36(21):1216-1218,1224
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To determine the rate of lymph node metastases in women with endometrial carci-noma and to compare the pattern of lymphatic spread of endometrial carcinoma with that of cervical carcino-ma. Methods: We retrospectively analyzed the lymphatic spread in 104 patients with endometrial carcinoma and 253 patients with cervical carcinoma. All of the patients underwent a complete pelvic and para-aortic lymphadenectomy from caudal to the median circumflex to the level of renal vessels. Results: The incidence of lymphatic metastases in the endometrial carcinoma group was higher than that in the cervical carcinoma group (22.1% vs 16.2 %). The pathologic grade (G_1: 12.1%; G_2: 21.4%; G_3: 34.5%) and depth of myometrial in-vasion (≤1/2: 11.9%; >1/2: 29%) were correlated with lymph node metastasis. The rates of para-aortic node involvement, pelvic lymph node involvement and involvement of both were 4.3%, 34.8% and 60.9% in the en-dometrial carcinoma group and 0%, 68.3% and 31.7% in the cervical carcinoma group. The rates of obturator node involvement were 73.9% and 70.7%, respectively; the rates of suprainguinal node involvement were 8.7% and 7.3%, respectively. Compared with cervical carcinoma, endometrial carcinoma showed higher rate of para-aortic and sacral node involvement (65.2% vs 31.7%, and 21.7% vs 17.1%) and lower rate of extamal iliac node involvement (17.4% vs 41.5%). Conclusion: Compared with cervical carcinoma, endometrial carcino-ma has a distinct lymphatic spread pattern and can directly metastasize to both pelvic lymph nodes and pa-ra-aortic lymph nodes with pelvic lymph node metastases being dominant. Positive lymph nodes are common-ly seen in cases of all pathological grades.
