Predicting pelvic lymph node metastasis in endometrial carcinoma.
BACKGROUND
To determine the possibility of individualizing the pelvic lymph node dissection in patients with endometrial cancer, the relationship between pelvic lymph node (PLN) metastasis and various prognostic factors was retrospectively investigated.


METHODS
From 1979 to 1994, 175 patients with endometrial carcinoma were treated with either total or radical hysterectomy combined with a PLN dissection as initial therapy. The prognostic factors examined included clinical stage, patient age, histological grade, the microscopic degree of myometrial invasion (DMI), cervical invasion, adnexal metastasis, and macroscopic tumor diameter (TD).


RESULTS
Of the 175 patients undergoing PLN dissection, 24 (14%) had PLN metastasis. An endometrial cancer with PLN metastasis had a significantly longer diameter than those without PLN metastasis. The frequency of PLN metastasis increased along with increases in tumor diameter. A logistic regression analysis revealed DMI and TD to be independently correlated with PLN metastasis. The formula based on the coefficients of TD and DMI obtained from the analysis also showed a good correlation, which allowed us to estimate the probability of patients having PLN metastasis.


CONCLUSIONS
DMI and TD could accurately estimate the status of PLN in endometrial carcinoma patients.
Kamura
T
T
Faculty of Medicine, Kyushu University, Fukuoka, 812-8582, Japan.
Yahata
H
H
Shigematsu
T
T
Ogawa
S
S
Amada
S
S
Kaku
T
T
Nakano
H
H
D000230:Adenocarcinoma / Q000556:secondary* / Q000601:surgery; D000328:Adult; D000368:Aged; D018269:Carcinoma, Endometrioid / Q000556:secondary / Q000601:surgery; D016889:Endometrial Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D016015:Logistic Models; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008679:Metaplasia; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010386:Pelvic Neoplasms / Q000556:secondary* / Q000601:surgery; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity