Low risk endometrial cancer: A study of pelvic lymph node metastasis

2003 ◽  
Vol 13 (1) ◽  
pp. 38-41 ◽  
Author(s):  
M. Watanabe ◽  
Y. Aoki ◽  
H. Kase ◽  
K. Fujita ◽  
K. Tanaka
Keyword(s):  
Endometrial Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Nodes ◽  
Pelvic Lymph Node ◽  
Tumor Diameter ◽  
Primary Therapy ◽  
Pelvic Lymph Nodes ◽  
Node Metastasis ◽  
Pelvic Lymph Node Metastasis

The aim of our study was to find preoperative or intraoperative pathologic indicators that would discriminate a subgroup of early corpus cancers that would not require lymphadenectomy. A retrospective review of the medical records of 107 patients with endometrioid adenocarcinoma, FIGO grade 1 or 2 tumor, myometrial invasion ≤50%, and no intraoperative evidence of macroscopic extrauterine spread was performed. Clinicopathologic risk factors were analyzed with Fisher ′s exact test with regards to pelvic lymph node metastasis. The median age of the patients was 54 years. Pelvic lymph node metastasis was observed in five of 107 patients (4.7%), where two patients with small tumors of 2 cm or less had positive pelvic lymph nodes. The presence of positive pelvic lymph nodes did not correlate with depth of invasion, histologic grade, cervical invasion, peritoneal cytology, menopausal status, preoperative serum CA125 level, or primary tumor diameter. Only lymphvascular space involvement (P < 0.0001) was significantly correlated to pelvic lymph node metastasis. We suggest that all patients with endometrial cancer who are taken to the operating room for primary therapy should be prepared to undergo extended surgical staging, except when clinical or operative factors increase patients' morbidity.

Effect of radiotherapy on pelvic lymph node metastasis in cervical cancer stages IB2–IVA: a retrospective analysis of two comparative series

2005 ◽  
Vol 15 (3) ◽  
pp. 468-474
Author(s):  
D. Dargent ◽  
G. Lamblin ◽  
P. Romestaing ◽  
X. Montbarbon ◽  
P. Mathevet ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Nodes ◽  
Pelvic Lymph Node ◽  
Tumor Diameter ◽  
Pelvic Radiotherapy ◽  
Node Metastasis ◽  
Pelvic Lymph Node Metastasis ◽  
Two Populations

Efficiency of radiotherapy in controlling lymph node metastasis is a controversial issue. A continuous series of 87 patients affected by cervical cancer stages IB2–IVA and treated using pelvic radiotherapy is presented. A retrospective comparison is made between two populations. In the two populations, a staging lymphadenectomy was carried out before the onset of the therapeutic program. In the first population (53 patients), the pelvic nodes only were dissected and in the second one (34 patients), the pelvic lymph nodes were left in place and the paraaortic nodes only were dissected. In both series, a completion surgery was performed after finalization of the radiotherapy. It was carried out at open abdomen in both series. It included a systematic pelvic dissection for the patients whose pelvic nodes had been intentionally left in place at the time of the initial staging lymphadenectomy. Both series were identical as far as classic risk factors were concerned (FIGO stage, maximal tumor diameter, lymphovascular space involvement). The radiotherapy administered to the pelvis was the same in both populations. The number of patients with pelvic lymph node metastasis was 21 (39.6%) in the first population versus 6 (17.6%) in the second one (P = 0.03). The percentage of positive lymph nodes among the retrieved lymph nodes was 18.94 in the first population versus 2.8 in the second one (P = 0.0001). Pelvic radiotherapy is likely to control most of the pelvic lymph node metastasis, but not all of them. Practical deductions and further developments are discussed.

The incidence of pelvic lymph node metastasis by FIGO staging for patients with adequately surgically staged endometrial adenocarcinoma of endometrioid histology

2008 ◽  
Vol 18 (2) ◽  
pp. 269-273 ◽  
Author(s):  
D. S. Chi ◽  
R. R. Barakat ◽  
M. J. Palayekar ◽  
D. A. Levine ◽  
Y. Sonoda ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Myometrial Invasion ◽  
Tumor Grade ◽  
Pelvic Lymph Node ◽  
Study Cohort ◽  
Node Metastasis ◽  
Figo Staging ◽  
Pelvic Lymph Node Metastasis

The seminal Gynecologic Oncology Group study on surgical pathologic spread patterns of endometrial cancer demonstrated the risk of pelvic lymph node metastasis for clinical stage I endometrial cancer based on tumor grade and thirds of myometrial invasion. However, the FIGO staging system assigns surgical stage by categorizing depth of myometrial invasion in halves. The objective of this study was to determine the incidence of pelvic lymph node metastasis in endometrial cancer based on tumor grade and myometrial invasion as per the current FIGO staging system. We reviewed the records of all patients who underwent primary surgical staging for clinical stage I endometrial cancer at our institution between May 1993 and November 2005. To make the study cohort as homogeneous as possible, we included only cases of endometrioid histology. We also included only patients who had adequate staging, which was defined as a total hysterectomy with removal of at least eight pelvic lymph nodes. During the study period, 1036 patients underwent primary surgery for endometrial cancer. The study cohort was composed of the 349 patients who met study inclusion criteria. Distribution of tumor grade was as follows: grade 1, 80 (23%); grade 2, 182 (52%); and grade 3, 87 (25%). Overall, 30 patients (9%) had pelvic lymph node metastasis. The incidence of pelvic lymph node metastasis in relation to tumor grade and depth of myometrial invasion (none, inner half, and outer half) was as follows: grade 1–0%, 0%, and 0%, respectively; grade 2–4%, 10%, and 17%, respectively; and grade 3–0%, 7%, and 28%, respectively. We determined the incidence of pelvic nodal metastasis in a large cohort of endometrial cancer patients of uniform histologic subtype in relation to tumor grade and a one-half myometrial invasion cutoff. These data are more applicable to current surgical practice than the previously described one-third myometrial invasion cutoff results.

Pelvic lymph node metastasis in endometrial cancer with no myometrial invasion

1996 ◽  
Vol 88 (2) ◽  
pp. 280-282 ◽  
Author(s):  
N TAKESHIMA ◽  
Y HIRAI ◽  
N TANAKA ◽  
T YAMAWAKI ◽  
K YAMAUCHI ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Myometrial Invasion ◽  
Pelvic Lymph Node ◽  
Node Metastasis ◽  
Pelvic Lymph Node Metastasis

Risk factors for pelvic lymph node metastasis in endometrial cancer

2019 ◽  
Vol 300 (4) ◽  
pp. 1007-1013 ◽  
Author(s):  
Yujie Li ◽  
Peishan Cong ◽  
Pan Wang ◽  
Chong Peng ◽  
Mingjun Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Endometrial Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Pelvic Lymph Node ◽  
Node Metastasis ◽  
Pelvic Lymph Node Metastasis

Clinical study of the clinical characteristics and prognosis of 1219 cases of endometrial cancer with lymph node metastasis

2021 ◽  
pp. 096032712110085
Author(s):  
Z Li ◽  
W Zhang ◽  
Z Luo ◽  
J Huang ◽  
L Li
Keyword(s):  
Endometrial Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Clinical Characteristics ◽  
Infiltration Depth ◽  
Pelvic Lymph Nodes ◽  
Node Metastasis ◽  
Metastasis Rate

To analyze the clinical characteristics and prognosis of endometrial cancer patients with lymph node metastasis to provide a reference for lymphadenectomy in endometrial cancer. The data used in this study were extracted from a tertiary hospital in Guangxi, China based on the hospital information system. 1219 patients with endometrial malignancy who were treated in our hospital. The lymph node metastasis rate was 9.8%. The metastasis rate of the abdominal aorta + pelvic lymph nodes (56.7%) was significantly higher than that of the pelvic (24.2%) or para-aortic (19.2%) lymph nodes alone. The proportion of postmenopausal patients with lymph node metastasis was higher than that of premenopausal patients. The proportion of patients with lymph node metastasis with vaginal and uterus involvement, HPV detection, Thinprep Cytologic Testresults, CRP level <10 ug/mL, G3 tumor grade, postoperative pathology indicating cervical invasion, lymphovascular invasion, and muscular infiltration depth > 1/2 was higher than that of patients without lymph node metastasis. The proportion of endometrial cancer patients with lymph node metastasis with CA125 ≥ 35 U/ml was higher than that of those with CA125 < 35 U/ml. The lymph node-positive rate is related to tissue differentiation, lymphangitic infiltration, cervical invasion, muscle infiltration depth > 1/2, and CA125 level. The metastasis rate of pelvic and para-aortic lymph nodes is higher than that of pelvic lymph nodes or para-aortic lymph nodes alone. There was no statistically significant difference in the overall survival rate among the three groups.

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