Annals of Surgical Oncology

, Volume 16, Issue 10, pp 2882–2887

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

Authors

  • Kwang-Beom Lee
    • Department of Obstetrics and Gynecology, Gil Medical CenterGachon University of Medicine and Science
  • Kyung-Do Ki
    • Department of Obstetrics and Gynecology, East-West Neo Medical CenterKyung Hee University
    • Department of Obstetrics and Gynecology, East-West Neo Medical CenterKyung Hee University
  • Jae-Kwan Lee
    • Department of Obstetrics and GynecologyKorea University College of Medicine
  • Jae Weon Kim
    • Department of Obstetrics and Gynecology & Cancer Research Institute, College of MedicineSeoul National University
  • Chi-Heum Cho
    • Department of Obstetrics and Gynecology, Dongsan Medical CenterKeimyung University
  • Seok-Mo Kim
    • Department of Obstetrics and GynecologyChonnam National University
  • Sang-Yoon Park
    • Center for Uterine CancerNational Cancer Center
  • Dae-Hoon Jeong
    • Department of Obstetrics and Gynecology, Busan Paik HospitalInje University
  • Ki-Tae Kim
    • Department of Obstetrics and Gynecology, Busan Paik HospitalInje University
Gynecologic Oncology

DOI: 10.1245/s10434-009-0535-0

Cite this article as:
Lee, K., Ki, K., Lee, J. et al. Ann Surg Oncol (2009) 16: 2882. doi:10.1245/s10434-009-0535-0

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.

Copyright information

© Society of Surgical Oncology 2009