Evaluation of preoperative criteria used to predict lymph node metastasis in endometrial cancer.
OBJECTIVE
To evaluate whether we could accurately predict lymph node (LN) metastasis with preoperative tests in endometrial cancer. Design. Retrospective study.


METHODS
Seoul National University Hospital, South Korea. Population. Three hundred patients with endometrial cancer who underwent surgical staging including lymphadenectomy between January 1999 and July 2007.


METHODS
We reviewed the medical records of 300 patients with endometrial cancer. The preoperative factors used to predict LN metastasis were as follows: old age (> or = 55 years), serum CA-125 level [level > or = 20 U/mL (if age < 50 years), level > or = 28 U/mL (if age > or = 50 years)], non-endometrioid histologic type and Grade 3, metastatic LN assessed by pelvic MRI or CT, and deep myometrial invasion assessed by pelvic MRI only. Logistic regression analysis was used to determine the significant predictive factors.


METHODS
Sensitivity/specificity and false positive/negative rates.


RESULTS
Thirty patients had LN metastasis. Although LN evaluation by pelvic MRI or CT and high CA-125 level were the significant independent predictors for LN metastasis, the sensitivity/specificity and false positive/negative rates for LN metastasis by these two combined preoperative tests were 86.7%/71.4% and 68.7%/2.7%, respectively. However, the sensitivity/specificity and false positive/negative rates for LN metastasis by six combined preoperative tests were 100%/28.9% and 84.6%/0%, respectively.


CONCLUSIONS
The six combined preoperative tests are useful in selecting patients without LN metastasis in endometrial cancer. Lymphadenectomy could be avoided in about 29% of patients with endometrial cancer who have no LN metastasis by using six combined preoperative tests.
Han
Seung-Su
SS
Department of Obstetrics and Gynecology, Chung-Ang University College of Medicine, Seoul, Korea.
Lee
Sang Hoon
SH
Kim
Dong Ho
DH
Kim
Jae Weon
JW
Park
Noh-Hyun
NH
Kang
Soon-Beom
SB
Song
Yong Sang
YS
D014408:Biomarkers, Tumor / Q000097:blood; D018394:CA-125 Antigen / Q000097:blood; D002277:Carcinoma / Q000473:pathology / Q000601:surgery; D016889:Endometrial Neoplasms / Q000473:pathology* / Q000601:surgery; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D015999:Multivariate Analysis; D009215:Myometrium / Q000473:pathology; D009361:Neoplasm Invasiveness; D010386:Pelvic Neoplasms / Q000556:secondary; D010388:Pelvis / Q000473:pathology; D011300:Preoperative Care; D012044:Regression Analysis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
D014408:Biomarkers, Tumor; D018394:CA-125 Antigen