Predictive Value of Kanagawa Cancer Center Scoring System for Lymph Node Metastasis and Need for Lymphadenectomy in Patients With Endometrial Cancer: A Validation Study

ObjectivesThe objective of this study was to determine the predictive value of Kanagawa Cancer Center (KCC) scoring system for lymph node metastasis and need for lymphadenectomy in patients with endometrial cancer.MethodsThis cross-sectional study was conducted during a 2-year period in a gynecologic oncology referral center in Southern Iran. We included a total number of 94 patients with endometrial cancer. Preoperative assessment included tumor volume, myometrium invasion, histology, and CA125. The KCC was calculated for all the patients. All the patients underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy along with dissection of pelvic and para-aortic lymph nodes. The histopathology of the dissected lymph nodes was considered as criterion standard, and the predictive value of KCC was evaluated accordingly.ResultsThe mean ± SD age of the patients was 56.8 ± 10.2 years. Overall, 26 patients (27.7%) tested positive for lymph node involvement. The sensitivity, specificity, positive predictive value, and negative predictive value of KCC for lymph node involvement was found to be 35.3%, 100%, 100%, and 64.7%, respectively. Overall, the predictive value according to the area under the curve measured by receiver operating characteristic curve was found to be 0.890 (0.823–0.956) indicative of moderate accuracy. Lymph node involvement was associated with higher Federation of Gynecology and Obstetrics stage (P< 0.001), higher tumor volume (P= 0.003), higher histological subtype (P< 0.001), positive CA125 (P< 0.001), and higher KCC score (P< 0.001).ConclusionsThe KCC scoring system has a moderate accuracy for predicting the lymph node involvement in patients with endometrial cancer.

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Predictive value of Kanagawa cancer center scoring system for lymph node metastasis in patients with endometrial cancer and comparing it to Al-Hilli scoring system

International Journal of Clinical Obstetrics and Gynaecology ◽

10.33545/gynae.2021.v5.i3d.929 ◽

2021 ◽

Vol 5 (3) ◽

pp. 222-227

Author(s):

Dr. Nawfal Azzo ◽

Dr. Shuhad Abdulameer

Keyword(s):

Endometrial Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Predictive Value ◽

Scoring System ◽

Cancer Center ◽

Node Metastasis

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Detection of Lymphovascular Invasion by D2-40 (Podoplanin) Immunoexpression in Endometrial Cancer

International Journal of Gynecological Cancer ◽

10.1097/igc.0b013e318269139b ◽

2012 ◽

Vol 22 (8) ◽

pp. 1442-1448 ◽

Cited By ~ 25

Author(s):

Sarah K. Weber ◽

Axel Sauerwald ◽

Martin Pölcher ◽

Michael Braun ◽

Manuel Debald ◽

...

Keyword(s):

Overall Survival ◽

Endometrial Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Lymphovascular Invasion ◽

Lymph Node Involvement ◽

Lymph Vessel ◽

Node Metastasis ◽

Lymph Vessel Invasion ◽

Node Involvement

BackgroundLymph node involvement is a major feature in tumor spread of endometrial cancer and predicts prognosis. Therefore, evaluation of lymph vessel invasion (LVI) in tumor tissue as a predictor for lymph node metastasis is of great importance. Immunostaining of D2-40 (podoplanin), a specific marker for lymphatic endothelial cells, might be able to increase the detection rate of LVI compared with conventional hematoxylin-eosin (H-E) staining. The aim of this retrospective study was to analyze the eligibility of D2-40–based LVI evaluation for the prediction of lymph node metastases and patients’ outcome.Patients and MethodsImmunohistochemical staining with D2-40 monoclonal antibodies was performed on paraffin-embedded tissue sections of 182 patients with primary endometrioid adenocarcinoma treated in 1 gynecologic cancer center. Tumors were screened for the presence of LVI. Correlations with clinicopathological features and clinical outcome were assessed.ResultsImmunostaining of D2-40 significantly increased the frequency LVI detection compared with conventional H-E staining. Lymph vessel invasion was identified by D2-40 in 53 (29.1%) of 182 tumors compared with 34 (18.3%) of 182 carcinomas by routine H-E staining (P = 0.001). D2-40 LVI was detectable in 81.0% (17/21) of nodal-positive tumors and significantly predicted lymph node metastasis (P = 0.001). Furthermore, D2-40 LVI was an independent prognostic factor for patients overall survival considering tumor stage, lymph node involvement, and tumor differentiation (P < 0.01). D2-40–negative tumors confined to the inner half of the myometrium showed an excellent outcome (5-year overall survival, 97.8%).ConclusionsD2-40–based LVI assessment improves the histopathological detection of lymphovascular invasion in endometrial cancer. Furthermore, LVI is of prognostic value and predicts lymph node metastasis. D2-40 LVI detection might help to select endometrial cancer patients who will benefit from a lymphadenectomy.

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228 Predictive factors of lymph node involvement and topography of lymph node metastasis in patients with epithelial ovarian cancer

10.1136/ijgc-2020-igcs.195 ◽

2020 ◽

Author(s):

D Atallah ◽

M Moubarak ◽

B Dagher ◽

N Khalil ◽

N El Kassis ◽

...

Keyword(s):

Ovarian Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Epithelial Ovarian Cancer ◽

Predictive Factors ◽

Lymph Node Involvement ◽

Node Metastasis ◽

Node Involvement

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Colorectal Cancer Presenting as Single Pulmonary Hilar Lymph Node Metastasis

Case Reports in Surgery ◽

10.1155/2018/5474919 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3

Author(s):

Ahmed M. Habib ◽

Xenophon Kassianides ◽

Samuel Chan ◽

Mahmoud Loubani ◽

Syed Qadri

Keyword(s):

Lymph Node ◽

Lymph Node Metastasis ◽

Mediastinal Lymph Node ◽

Lymph Node Involvement ◽

Pulmonary Metastasectomy ◽

Hilar Lymph Node ◽

Node Metastasis ◽

Mediastinal Metastasis ◽

Node Involvement ◽

Hilar Lymph Node Metastasis

Colorectal carcinoma is the second biggest cancer responsible for mortality. Lung metastasis is the commonest, following the liver. It is not uncommon to perform pulmonary metastasectomy and identify mediastinal metastasis. Previous studies have identified incidental lymph node involvement following routine mediastinal lymph node clearance in 20–50% of cases. However, solitary intrathoracic lymph node metastasis is exceedingly rare. Even when present, it is usually metachronous. In our case, we present an exceedingly rare case whereby the intrathoracic lymph node metastasis is solitary, not accompanying pulmonary disease and with no liver metastasis. We also review the evidence for mediastinal lymphadenectomy in the literature.

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Lymph Node Metastasis in Patients With Endometrioid Endometrial Cancer: Overtreatment Is the Main Issue

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000000937 ◽

2017 ◽

Vol 27 (4) ◽

pp. 748-753 ◽

Cited By ~ 8

Author(s):

Alper Karalok ◽

Taner Turan ◽

Derman Basaran ◽

Osman Turkmen ◽

Gunsu Comert Kimyon ◽

...

Keyword(s):

Endometrial Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Histological Grade ◽

Myometrial Invasion ◽

Lymph Node Involvement ◽

Node Metastasis ◽

Deep Myometrial Invasion ◽

Endometrioid Endometrial Cancer ◽

Grade 3

ObjectiveThe aim of this study was to evaluate the effectiveness of histological grade, depth of myometrial invasion, and tumor size to identify lymph node metastasis (LNM) in patients with endometrioid endometrial cancer (EC).MethodsA retrospective computerized database search was performed to identify patients who underwent comprehensive surgical staging for EC between January 1993 and December 2015. The inclusion criterion was endometrioid type EC limited to the uterine corpus. The associations between LNM and surgicopathological factors were evaluated by univariate and multivariate analyses.ResultsIn total, 368 patients were included. Fifty-five patients (14.9%) had LNM. Median tumor sizes were 4.5 cm (range, 0.7–13 cm) and 3.5 cm (range, 0.4–33.5 cm) in patients with and without LNM, respectively (P = 0.005). No LMN was detected in patients without myometrial invasion, whereas nodal spread was observed in 7.7% of patients with superficial myometrial invasion and in 22.6% of patients with deep myometrial invasion (P < 0.0001). Lymph node metastasis tended to be more frequent in patients with grade 3 disease compared with those with grade 1 or 2 disease (P = 0.131).ConclusionsThe risk of lymph node involvement was 30%, even in patients with the highest-risk uterine factors, that is, those who had tumors of greater than 2 cm, deep myometrial invasion, and grade 3 disease, indicating that 70% of these patients underwent unnecessary lymphatic dissection. A precise balance must be achieved between the desire to prevent unnecessary lymphadenectomy and the ability to diagnose LNM.

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A prospective study to evaluate the impact and independency of depth of invasion in comparison with other clinicopathologic prognostic variables in oral cavity malignancy

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20200149 ◽

2020 ◽

Vol 6 (2) ◽

pp. 347

Author(s):

Subbiah Shanmugam ◽

Gopu Govindasamy ◽

X. Gerald Anand Raja

Keyword(s):

Lymph Node ◽

Lymph Node Metastasis ◽

Oral Cavity ◽

Staging System ◽

Lymph Node Involvement ◽

Stage Migration ◽

Depth Of Invasion ◽

Node Metastasis ◽

Node Involvement ◽

The Impact

Background: Depth of invasion is included in the staging of oral cavity malignancies in the recent 8th edition of American Joint Committee on Cancer or tumour, node and metastasis staging system. This study analyses the impact of diffuse optical imaging (DOI) on incidence of lymph node involvement, stage migration, postoperative margin and independency.Methods: Postoperative HPE of fifty patients with oral cavity malignancy operated in our institute from January 2018 were collected. Depth of invasion and other pathological parameters were documented. DOI divided into three groups and statistical analysis done. Results: No lymph node metastasis is found in superficial tumours, 43% of intermediate thickness and 76% of deep tumours had lymph node involvement. Positive margin is seen only in patients with tumour DOI more than 0.5 cm, more than 50% of deep tumours had close margins while 75% of superficial tumours had adequate margin. Out of the 24 T3 tumours in this study 13 were upstaged due to inclusion of DOI, which would have been T2 according to the previous staging system. There is 54.1% (13 out of 24) upstaging in T3 tumours (T2 to T3), 23% (3 out of 13) in T2 (T1 to T2). There is no significant correlation between DOI and anatomical site, tumour size, tumour thickness, lymphovascular invasion and grade.Conclusions: Depth of invasion in oral cavity malignancies impacts adversely lymph node metastasis and margin status. It is an independent prognostic factor in oral cavity malignancy.

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