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Original Research

Open Access

Risk factors of lymph node metastasis in patients with type II endometrial carcinoma: a retrospective signle-center study

  • Nan Wang1
  • Zhi-feng Yan1
  • Ming-xia Ye1
  • Ming-xia Li1
  • Ming-yang Wang1
  • Yuan-guang Meng1,*,

1Department of Gynecology and Obstetrics, The First Medical Center of Chinese PLA General Hospital, 100853 Beijing, China

DOI: 10.22514/ejgo.2023.018 Vol.44,Issue 2,April 2023 pp.19-24

Submitted: 12 June 2022 Accepted: 11 August 2022

Published: 15 April 2023

*Corresponding Author(s): Yuan-guang Meng E-mail: meng6512@vip.sina.com

Abstract

In this study, we explored the risk factors for lymph node metastasis in patients with type II endometrial carcinoma (EC). Patients diagnosed with type II EC who underwent staged surgery and lymph node dissection were included. Univariate analysis was performed using a chi-square test for factors such as age, body mass index (BMI), menopausal status, histologic type, histologic grade, myometrial invasion, lymphatic vascular invasion (LVSI), tumor volume index, and para-aortic lymph node (PALN) or pelvic lymph node (PLN) metastasis. An analysis of multivariate factors was performed on the factors that were statistically significant in the univariate analysis. Pelvic lymph node metastasis was identified in 38 of the 184 patients with type II EC. Univariate analyses revealed that age ≥55 years, menopause, more than one-half myometrial invasion, and LVSI were risk factors for pelvic lymph node metastasis. Multivariate analysis indicated that myometrial invasion of more than one-half (hazard ratio (HR): 4.259) and LVSI (HR: 3.317) were independent risk factors for pelvic lymph node metastasis. Para-aortic lymph node metastasis was identified in 13 of the 184 patients with type II EC. Univariate analysis indicated that para-aortic lymph node metastasis was significantly associated with LVSI and pelvic lymph node metastases. Multivariate analysis suggested that pelvic lymph node metastasis (HR: 5.887) was an independent risk factor for para-aortic lymph node metastasis. LVSI and myometrial invasion depth >1/2 were significant predictors of pelvic lymph node metastasis in patients with type II EC. Patients with type II EC who have pelvic lymph node metastasis may be at risk of para-aortic lymph node metastasis.


Keywords

Risk factors; Lymph node metastasis; Type II endometrial carcinoma


Cite and Share

Nan Wang,Zhi-feng Yan,Ming-xia Ye,Ming-xia Li,Ming-yang Wang,Yuan-guang Meng. Risk factors of lymph node metastasis in patients with type II endometrial carcinoma: a retrospective signle-center study. European Journal of Gynaecological Oncology. 2023. 44(2);19-24.

References

[1] Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2021. CA: A Cancer Journal for Clinicians. 2021; 71: 7–33.

[2] Chen W, Zheng R, Baade PD, Zhang S, Zeng H, Bray F, et al. Cancer statistics in China, 2015. CA: A Cancer Journal for Clinicians. 2016; 66: 115–132.

[3] Kurman RJ, Carcangiu ML, Herrington CS, Young RH. WHO classifi-cation of tumours of female reproductive organs. 4th ed. International Agency for Research on Cancer: Lyon. 2014.

[4] Amant F, Mirza MR, Koskas M, Creutzberg CL. Cancer of the corpus uteri. International Journal of Gynecology & Obstetrics. 2018; 143: 37–50.

[5] Koskas M, Amant F, Mirza MR, Creutzberg CL. Cancer of the corpus uteri: 2021 update. International Journal of Gynecology & Obstetrics. 2021; 155: 45–60.

[6] Pölcher M, Rottmann M, Brugger S, Mahner S, Dannecker C, Kiechle M, et al. Lymph node dissection in endometrial cancer and clinical outcome: a population-based study in 5546 patients. Gynecologic Oncology. 2019; 154: 65–71.

[7] DiSaia PJ, Creasman WT, Boronow RC, Blessing JA. Risk factors and recurrent patterns in stage I endometrial cancer. American Journal of Obstetrics and Gynecology. 1985; 151: 1009–1015.

[8] Frederick PJ, Straughn JM. The role of comprehensive surgical staging in patients with endometrial cancer. Cancer Control. 2009; 16: 23–29.

[9] Todo Y, Sakuragi N, Nishida R, Yamada T, Ebina Y, Yamamoto R, et al. Combined use of magnetic resonance imaging, CA 125 assay, histologic type, and histologic grade in the prediction of lymph node metastasis in endometrial carcinoma. American Journal of Obstetrics and Gynecology. 2003; 188: 1265–1272.

[10] Tanase Y, Takahama J, Kawaguchi R, Kobayashi H. Analysis of risk factors for lymphatic metastasis in endometrial carcinoma and utility of three-dimensional magnetic resonance imaging in gynecology. World Journal of Oncology. 2018; 9: 74–79.

[11] Hou JY, McAndrew TC, Goldberg GL, Whitney K, Shahabi S. A clinical and pathologic comparison between stage-matched endometrial intraepithelial carcinoma and uterine serous carcinoma: is there a difference? Reproductive Sciences. 2014; 21: 532–537.

[12] Bowker SL, Richardson K, Marra CA, Johnson JA. Risk of breast cancer after onset of type 2 diabetes: evidence of detection bias in postmenopausal women. Diabetes Care. 2011; 34: 2542–2544.

[13] Tokunaga H, Shimada M, Ishikawa M, Yaegashi N. TNM classification of gynaecological malignant tumours, eighth edition: changes between the seventh and eighth editions. Japanese Journal of Clinical Oncology. 2019; 49: 311–320.

[14] McCluggage WG. Pathologic staging of endometrial carcinomas: selected areas of difficulty. Advances in Anatomic Pathology. 2018; 25: 71–84.

[15] Höhn AK, Brambs CE, Hiller GGR, May D, Schmoeckel E, Horn L. 2020 WHO classification of female genital tumors. Geburtshilfe Frauenheilkd. 2021; 81: 1145–1153.

[16] Soslow RA, Tornos C, Park KJ, Malpica A, Matias-Guiu X, Oliva E, et al. Endometrial carcinoma diagnosis: use of FIGO grading and genomic subcategories in clinical practice: recommendations of the international society of gynecological pathologists. International Journal of Gynecological Pathology. 2019; 38: S64–S74.

[17] Brooks RA, Fleming GF, Lastra RR, Lee NK, Moroney JW, Son CH, et al. Current recommendations and recent progress in endometrial cancer. CA: A cancer journal for clinicians. 2019; 69: 258–279.

[18] Suarez AA, Felix AS, Cohn DE. Bokhman redux: endometrial cancer “types” in the 21st century. Gynecologic Oncology. 2017; 144: 243–249.

[19] Bhatla N, Denny L. FIGO cancer report 2018. International Journal of Gynecology & Obstetrics. 2018; 143: 2–3.

[20] Koh W, Abu-Rustum NR, Bean S, Bradley K, Campos SM, Cho KR, et al. Uterine neoplasms, Version 1.2018, NCCN clinical practice guidelines in oncology. Journal of the National Comprehensive Cancer Network. 2018; 16: 170–199.

[21] Nomura H, Aoki D, Suzuki N, Susumu N, Suzuki A, Tamada Y, et al. Analysis of clinicopathologic factors predicting para-aortic lymph node metastasis in endometrial cancer. International Journal of Gynecological Cancer. 2006; 16: 799–804.

[22] Bogani G, Dowdy SC, Cliby WA, Ghezzi F, Rossetti D, Mariani A. Role of pelvic and para-aortic lymphadenectomy in endometrial cancer: Current evidence. The Journal of Obstetrics and Gynaecology Research. 2014; 40: 301–311.

[23] Kumar S, Mariani A, Bakkum-Gamez JN, Weaver AL, McGree ME, Keeney GL, et al. Risk factors that mitigate the role of paraaortic lymphadenectomy in uterine endometrioid cancer. Gynecologic Oncology. 2013; 130: 441–445.

[24] Kumar S, Podratz KC, Bakkum-Gamez JN, Dowdy SC, Weaver AL, McGree ME, et al. Prospective assessment of the prevalence of pelvic, paraaortic and high paraaortic lymph node metastasis in endometrial cancer. Gynecologic Oncology. 2014; 132: 38–43.

[25] Sari ME, Yalcin İ, Sahin H, Meydanli MM, Gungor T. Risk factors for paraaortic lymph node metastasis in endometrial cancer. International Journal of Clinical Oncology. 2017; 22: 937–944.

[26] Marin F, Pleşca M, Bordea CI, Voinea SC, Burlănescu I, Ichim E, et al. Postoperative surgical complications of lymphadenohysterocolpectomy. Journal of Medicine and Life. 2014; 7: 60–66.

[27] Panici PB, Basile S, Maneschi F, Lissoni AA, Signorelli M, Scambia G, et al. Systematic pelvic lymphadenectomy vs. no lymphadenectomy in early-stage endometrial carcinoma: randomized clinical trial. Journal of the National Cancer Institute. 2008; 100: 1707–1716.

[28] ASTEC study group, Kitchener H, Swart AM, Qian Q, Amos C, Parmar MK. Efficacy of systematic pelvic lymphadenectomy in endometrial cancer (MRC ASTEC trial): a randomised study. Lancet. 2009; 373: 125–136.

[29] Perrone AM, Casadio P, Formelli G, Levorato M, Ghi T, Costa S, et al. Cervical and hysteroscopic injection for identification of sentinel lymph node in endometrial cancer. Gynecologic Oncology. 2008; 111: 62–67.

[30] Holub Z, Jabor A, Kliment L. Comparison of two procedures for sentinel lymph node detection in patients with endometrial cancer: a pilot study. European Journal of Gynaecological Oncology. 2002; 23: 53–57.


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