Prediction of lymph node metastasis in patients with apparent early endometrial cancer.
10.5468/ogs.2015.58.5.385
- Author:
Joo Hyuk SON
1
;
Tae Wook KONG
;
Su Hyun KIM
;
Jiheum PAEK
;
Suk Joon CHANG
;
Eun Ju LEE
;
Hee Sug RYU
Author Information
1. Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Korea. drchang@ajou.ac.kr
- Publication Type:Original Article
- Keywords:
CA-125;
Endometrial neoplasms;
Lymph node;
Metastasis;
Tumor grade
- MeSH:
Biopsy;
Carcinoma, Endometrioid;
Endometrial Neoplasms*;
Female;
Gynecology;
Humans;
Incidence;
Lymph Nodes*;
Magnetic Resonance Imaging;
Medical Records;
Multivariate Analysis;
Neoplasm Metastasis*
- From:Obstetrics & Gynecology Science
2015;58(5):385-390
- CountryRepublic of Korea
- Language:English
-
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.
