Evaluation of risk factors for pelvic and paraaortic lymph node metastasis in endometrioid type endometrial cancer

Evaluation of risk factors for pelvic and paraaortic lymph node metastasis in endometrioid type endometrial cancer

Aim: Determining the relationship between clinical and pathological features in endometrial cancer is essential for both prognostic and potential therapeutic benefits. In this study, we aimed to investigate the relationship between pelvic and paraaortic lymph node (PLN and PALN) metastasis and prognostic factors in patients with endometrial cancer (EC).Material and Method: Medical records of patients who underwent primary surgery for EC in our gynecological oncology center between the 2016 and 2018 were reviewed retrospectively. The relationship between pelvic and paraaortic lymph node metastasis was evaluated with data such as patient age, body mass index, serum CA 125 level, macroscopic tumor diameter, and patients’ risk groups.Results: Fifty-seven patients with EC were evaluated. Lymph node involvement was detected in 10 patients (17.5%). Acording to Modiffied Mayo criterias ; the patients with grade 3 EC had a higher risk of metastasis compared to other grades (p=0.025). Patients with lymph node metastases had a greater depth of invasion (p=0.001). There was no relationship between tumor size and lymph node metastasis (p=0.494). In the logistic regression analysis, the depth of invasion was found to be an independent risk factor for lymph node metastasis. There was no significant relationship between the presence of PLN and PALN metastases in patients with high-risk endometrial cancer, but the presence of PALN metastasis was significant in patients with low-risk endometrial cancer with PLN metastasis (p=0.002).Conclusion: These findings support the idea that routine evaluation of tumor invasion depth during endometrial cancer surgery may be useful in predicting lymph node metastasis and guiding the operation.

___

  • Braun MM, Overbeek-Wager EA, Grumbo RJ. Diagnosis and Management of Endometrial Cancer. Am Fam Physician 2016; 15: 93: 468-74.
  • T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü. Türkiye Kanser İstatistikleri 2017. Available online: https://hsgm.saglik.gov.tr/depo/birimler/kanser-db/istatistik/Turkiye_Kanser_Istatistikleri_2017.pdf
  • Lewin SN, Herzog TJ, Medel NIB, et al. Comparative performance of the 2009 International Federation of Gynecology and Obstetrics’ staging system for uterine corpus cancer. Obstet Gynecol 2010; 116: 1141-9.
  • Akbayir O, Corbacioglu A, Goksedef BP, et al. The novel criteria for predicting pelvic lymph node metastasis in endometrioid adenocarcinoma of endometrium. Gynecol Oncol 2012; 125: 400–403.
  • Sarı ME, Meydanlı ME, Yalçın İ, et al. Risk factors for lymph node metastasis among lymphovascular space ınvasion-positive women with endometrioid endometrial cancer clinically confi ned to the uterus. Oncol Res Treat 2018; 41: 750-4.
  • Aalders JG, Thomas G. Endometrial cancer—revisiting the importance of pelvic and para aortic lymph nodes. Gynecol Oncol 2007; 10: 222-31.
  • Creutzberg CL. Lymphadenectomy in apparent early-stage endometrial carcinoma: Do numbers count? J Clin Oncol 2005; 40: 55-65.
  • Sorosky JI. Endometrial cancer. Obstet Gynecol 2012; 120: 383-97.
  • Todo Y, Takeshita S, Okamoto K, e Yamashiro K, Kato H. Implications of para-aortic lymph node metastasis in patients with endometrial cancer without pelvic lymph node metastasis. J Gynecol Oncol 2017; 28: e59.
  • Mariani A, Webb MJ, Keeney GL, Haddock MG, Calori G, Podratz KC. Low-risk corpus cancer: is lymphadenectomy or radiotherapy necessary? Am J Obstet Gynecol 2000; 182: 1506–19.
  • Fotopoulou C, Savvatis K, Kraetschell R, Schefold JC, Lichtenegger W, Sehouli J. Systematic pelvic and aortic lymphadenectomy in intermediate and high-risk endometrial cancer: lymph-node mapping and identification of predictive factors for lymph-node status. Eur J Obstet Gynecol Reprod Biol 2010; 149: 199-203.
  • Karube Y, Fujimoto T, Takahashi O, et al. Histopathological prognostic factors predicting para-aortic lymph node metastasis in patients with endometrioid uterine cancer. Gynecol Oncol 2010; 118: 151-4.
  • Nomura H, Aoki D, Suzuki N, et al. Analysis of clinicopathologic factors predicting para-aortic lymph node metastasis in endometrial cancer. Int J Gynecol Cancer 2006; 16: 799-804.
  • Turan AT, Yıldırım BA, Üreyen I, et al. Creating a risk model to determine paraaortic lymph node involvement in endometrial carcinoma. Turk J Med Sci 2012; 42: 1259-67.
  • Taş EE, Yeğin GF, Keskin HL, Kır EA, Yavuz AF. Assessment of risk factors for lymph node metastasis in endometrial cancer. Istanbul Med J 2019; 20: 8-12.
  • Yokoyama Y, Maruyama H, Sato S, Saito Y. Indispensability of pelvic and paraaortic lymphadenectomy in endometrial cancers. Gynecol Oncol 1997; 64: 411-17.
Journal of Health Sciences and Medicine-Cover
  • Yayın Aralığı: Yılda 6 Sayı
  • Başlangıç: 2018
  • Yayıncı: MediHealth Academy Yayıncılık
Sayıdaki Diğer Makaleler

The effect of polycystic ovary syndrome history on neonatal anogenital distance: a prospective study in Turkish population

Burak BAYRAKTAR, Cüneyt Eftal TANER

Regulatory immune cells: a review of the novel paradigm of primary Sjogren's syndrome

Selda UCAR

Face-to-face assessment versus tele-assessment of chronic stroke patients: do the results meet the needs?

İlknur SARAL, Serkan SURUCU, Yasemin Tuğçe YAYLA, Engin ÇAKAR

Fetal cavum septum pellucidum nomogram and its relationship with fetal Doppler: a prospective study of a Turkish population

Burak BAYRAKTAR, Cüneyt Eftal TANER

Prognostic role of primary tumor metabolic-volumetric parameters of 18F-fluorodeoxyglucose positron emission tomography in tongue squamous cell carcinoma

Uğuray AYDOS, Süleyman CEBECİ

FeNO, systemic inflammation and other risk factors for osteoporosis in COPD

Ömür GÜNGÖR, A. Füsun KALPAKLIOĞLU

Is the magnesium phosphate ratio a predictor of arrhythmia in patients undergoing hemodialysis?

Ferhat YURDAM, Muhittin Doruk TATLI

Determination of the frequency of influenza-A and B antigens in swab samples in differentiating the diagnosis of influenza infection from other causes of upper respiratory tract infection

Ali SAĞLIK

Treatment of distal femur fractures with retrograde intramedullary nailing utilizing a tibial nail

Yılmaz ERGİŞİ, Mesut TIKMAN, Selçuk KORKMAZER, Ozan ALTUN, Halil KEKEÇ, Erdi ÖZDEMİR, Uygar DAŞAR

Bibliometric analysis of the most cited articles on congenital cataract from 1980 to 2022

Ayşin Tuba KAPLAN