Preoperative prediction model of lymph node metastasis in endometrial cancer.
BACKGROUND
We aimed to develop a preoperative prediction model identifying the low-risk group for lymph node metastasis in endometrial cancer.


METHODS
In 110 patients who underwent preoperative magnetic resonance imaging and serum CA-125 test, logistic analysis was performed to identify predictors. The coefficients obtained from logistic regression were used to construct a scoring system, and a receiver operator characteristic curve was created.


RESULTS
Lymph node metastases were found in 14 (12.7%) of 110 patients. After multivariate logistic regression analysis, histologic grade, preoperative CA-125 levels, disease extent, and myometrial invasion assessed by magnetic resonance imaging were selected as viable predictors. The scoring system was internally validated using bootstrapping (P < 0.001), and receiver operator characteristic curve yielded the area under the curve of 0.902. The patients with the score of 0 or 1 (57.3%) were identified as a low-risk group, and no nodal metastasis was observed among them (negative predictive value, 100%: 95% confidence interval, 94.3%-100%).


CONCLUSIONS
The current study suggests that preoperative prediction system to identify the risk of lymph node metastasis is feasible. This model may be useful in preoperative counseling about cost and benefit of systemic lymph node dissection.
Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, Republic of Korea.
Jung-Yun
JY
Lee
Dae-Chul
DC
Jung
Se-Hyun
SH
Park
Myung-Chul
MC
Lim
Sang-Soo
SS
Seo
Sang-Yoon
SY
Park
Sokbom
S
Kang
D000328:Adult; D000368:Aged; D001774:Blood Chemical Analysis; D018394:CA-125 Antigen / Q000032:analysis / Q000097:blood; D002277:Carcinoma / Q000097:blood / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D003661:Decision Support Techniques; D003944:Diagnostic Techniques, Obstetrical and Gynecological; D016889:Endometrial Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D016015:Logistic Models; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D059035:Perioperative Period; D011379:Prognosis; D012189:Retrospective Studies; D055815:Young Adult
D018394:CA-125 Antigen