A predictive model for lymph node metastasis using tumor location in presumed early-stage endometrioid endometrial cancer patients

다국어 초록 (Multilingual Abstract)

Objective: The aim of this study was to identif y high- and low-risk subgroups of patientswith lymph node (LN) metastasis in presumed early-stage endometrioid endometrial cancer(EC) patients.
Methods: Clinicopathologic data of presumed early-stage endometrioid EC patients (n=361)treated with lymphadenectomy between March 2000 and July 2022 were analyzed. None ofthe patient had definite evidence of LN metastasis in a preoperative magnetic resonanceimaging (MRI). A received operating characteristic cur ve analysis was conducted to definethe sensitivity and specificity for the combined preoperative risk factors for LN metastasis,which was determined by multivariate analysis.
Results: Nineteen patients (5.3%) had LN metastasis. Multivariate analysis identified cer vicalstromal invasion on MRI (odds ratio [OR]=4.386; 95% confidence inter val [CI]=1.020–18.852;p=0.047), cornual location of tumor on MRI (OR=36.208; 95% CI=7.902–165.913; p<0.001), andlower uterine segment/isthmic location of tumor on MRI (OR=8.454; 95% CI=1.567–45.610;p=0.013) as independent prognostic factors associated with LN metastasis. Patients werecategorized into low- and high-risk groups according to risk criteria. Significant differences inthe rates of LN metastasis were obser ved between the two groups (0.4% vs. 22.2%, p<0.001).
Conclusion: Approximately 95% of presumed early-stage endometrioid EC patients did nothave LN metastasis. A model using tumor location was significantly correlated with the riskof LN metastasis. Even in presumed early-stage endometrioid EC patients, therefore, tumorlocation should be investigated to determine whether to perform LN assessment.