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

  • Gynecologic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

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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Acknowledgment

This study was supported by a grant from the Korean Research Foundation, funded by the Korean Government (MOEHRD, Basic Research Promotion Fund, KRF-2007-I00458-E00287).

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Gil Medical Center, Gachon University of Medicine and Science, Incheon, South Korea

    Kwang-Beom Lee MD, PhD

  2. Department of Obstetrics and Gynecology, East-West Neo Medical Center, Kyung Hee University, Seoul, South Korea

    Kyung-Do Ki MD, PhD & Jong-Min Lee MD, PhD

  3. Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, South Korea

    Jae-Kwan Lee MD, PhD

  4. Department of Obstetrics and Gynecology & Cancer Research Institute, College of Medicine, Seoul National University, Seoul, South Korea

    Jae Weon Kim MD, PhD

  5. Department of Obstetrics and Gynecology, Dongsan Medical Center, Keimyung University, Daegu, South Korea

    Chi-Heum Cho MD, PhD

  6. Department of Obstetrics and Gynecology, Chonnam National University, Gwangju, South Korea

    Seok-Mo Kim MD, PhD

  7. Center for Uterine Cancer, National Cancer Center, Goyang, South Korea

    Sang-Yoon Park MD, PhD

  8. Department of Obstetrics and Gynecology, Busan Paik Hospital, Inje University, Busan, South Korea

    Dae-Hoon Jeong MD, PhD & Ki-Tae Kim MD, PhD

Authors
  1. Kwang-Beom Lee MD, PhD
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  2. Kyung-Do Ki MD, PhD
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  6. Chi-Heum Cho MD, PhD
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  7. Seok-Mo Kim MD, PhD
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Corresponding author

Correspondence to Jong-Min Lee MD, PhD.

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Lee, KB., Ki, KD., Lee, JM. et al. The Risk of Lymph Node Metastasis Based on Myometrial Invasion and Tumor Grade in Endometrioid Uterine Cancers: A Multicenter, Retrospective Korean Study. Ann Surg Oncol 16, 2882–2887 (2009). https://doi.org/10.1245/s10434-009-0535-0

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  • DOI: https://doi.org/10.1245/s10434-009-0535-0

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