title: Clinical significance of tumor volume in endometrial cancer: a Japan-Korea cooperative study.
abstract: OBJECTIVE
  The aim of this study was to elucidate the significance of tumor volume as a risk factor for predicting lymph node metastasis.
  
  
  METHODS
  We applied the tumor volume index to the data that were collected for 327 Korean patients with endometrial cancer who underwent preoperative assessment including magnetic resonance imaging (MRI) and subsequent surgery including systematic lymphadenectomy. The volume index, which we previously reported in the literature, was defined as the product of maximum longitudinal diameter along the uterine axis, maximum anteroposterior diameter in a sagittal section image, and maximum horizontal diameter in a horizontal section image according to MRI data, from 425 Japanese women with endometrial cancer. Relationships between lymph node metastasis and results of preoperative examinations including volume index were analyzed by logistic regression analysis.
  
  
  RESULTS
  The prevalence of affected lymph nodes was 14.2%. Multivariate analysis showed that high-grade histology assessed by endometrial biopsy [odds ratio (OR); 2.9, 95% confidence interval (CI): 1.4-6.4], volume index (OR; 2.4, 95% CI: 1.1-5.3), node enlargement assessed by MRI (OR; 4.2, 95% CI: 1.4-13.2), and high serum cancer antigen (CA)125 level (OR; 3.6, 95% CI: 1.6-8.1) were significantly and independently related to lymph node metastasis. When volume index was excluded from the analysis, myoinvasion assessed by MRI was an independent risk factor for lymph node metastasis as well as high-grade histology, node enlargement, and high serum CA125 level.
  
  
  CONCLUSIONS
  Volume index is compatible with myometrial invasion as a factor for predicting lymph node metastasis in endometrial cancer.
authors: Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, 4-2 Kikusui, Shiroishi-ku, Sapporo 003-0804, Japan. Electronic address: yukiharu@sap-cc.go.jp.
authors: Yukiharu
authors: Y
authors: Todo
authors: Hyuck-Jae
authors: HJ
authors: Choi
authors: Sokbom
authors: S
authors: Kang
authors: Jae-Weon
authors: JW
authors: Kim
authors: Joo-Hyun
authors: JH
authors: Nam
authors: Hidemichi
authors: H
authors: Watari
authors: Akiko
authors: A
authors: Tamakoshi
authors: Noriaki
authors: N
authors: Sakuragi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D016889:Endometrial Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007391:International Cooperation; D007564:Japan / Q000453:epidemiology; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011300:Preoperative Care; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D055815:Young Adult
keywords: Endometrial cancer; Lymph node metastasis; Lymphadenectomy; Risk assessment; Tumor size; Tumor volume