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The Risk of Lymph Node Metastasis Based on Myometrial Invasion and Tumor Grade in Endometrioid Uterine Cancers: A Multicenter, Retrospective Korean Study

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Author(s)
조치흠
Alternative Author(s)
Cho, Chi Heum
Publication Year
2009
Abstract
Background. Knowledge of the risk factors for lymph
node metastasis (LNM) is necessary to treat patients with
endometrioid uterine cancer to optimize and further individualize
treatment. This study was designed to determine
the risk of LNM based on myometrial invasion and tumor
grade in endometrioid uterine cancer.
Methods. The authors retrospectively reviewed the medical
records and pathological findings of 834 patients who
underwent surgical staging, including pelvic lymphadenectomy
with or without para-aortic lymphadenectomy, for
endometrioid uterine cancer from 2002 to 2008 in Korea.
Results. Of the 834 patients with endometrioid uterine
cancer, 107 (12.8%) patients had LNM. Sixty-one (57%)
patients had only pelvic LNM, 39 (36.4%) had pelvic and
para-aortic LNM, and 7 (6.6%) had isolated para-aortic
LNM. Tumor grade, myometrial invasion, tumor diameter,
cervical extension, lymphovascular space invasion, and
adnexal involvement were found to be significant predictors
of LNM. Of 215 patients with no myometrial invasion
and tumor grade I/II, only 1 (0.47%) had LNM. However,
in other patients, the risk of LNM was significant and at
least[3.5%. Furthermore, the risk of LNM was found to
be well correlated with increases in myometrial invasion
and tumor grade based on subgroup analyses, when
patients with no myometrial invasion and tumor grade I/II
were used as a reference group (p\0.0001).
Conclusions. Patients with endometrioid uterine cancers
with no myometrial invasion and tumor grade I/II might
have minimal risk of LNM, whereas others might require
complete pelvic and para-aortic lymphadenectomy for
surgical staging.
Department
Dept. of Obstetrics & Gynecology (산부인과학)
Publisher
School of Medicine
Citation
Annals of Surgical Oncology, Vol.16(10) : 2882-2887, 2009
Type
Article
ISSN
1068-9265
DOI
10.1245/s10434-009-0535-0
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/35045
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