Factors Predictive of Retroperitoneal Lymph Node Metastasis in Endometrial Cancer

Authors

  • Cecília Urzal Departamento de Ginecologia e Obstetrícia. Centro Hospitalar Tondela-Viseu. Viseu. Portugal.
  • Rita Sousa Serviço de Ginecologia. Instituto Português de Oncologia. Coimbra. Portugal.
  • Vítor Baltar Serviço de Ginecologia. Instituto Português de Oncologia. Coimbra. Portugal.
  • Paulo Correia Serviço de Ginecologia. Instituto Português de Oncologia. Coimbra. Portugal.
  • Eugénia Cruz Serviço de Anatomia Patológica. Instituto Português de Oncologia. Coimbra. Portugal.
  • Daniel Pereira da Silva Serviço de Ginecologia. Instituto Português de Oncologia. Coimbra. Portugal.

DOI:

https://doi.org/10.20344/amp.4115

Abstract

Introduction: It has been suggested that a complete staging may be safely omitted in endometrial carcinoma patients at low risk for lymph node metastasis. The purposes of our study were to explore the prognostic significance of pathologic factors for pelvic and paraaortic nodal spread and to validate the Mayo algorithm in order to identify patients in whom lymphadenectomy may be avoided.
Material and Methods: We conducted a retrospective review including 208 patients, regarding the evaluation of pathologic variables and nodal metastases. Statistical analysis was performed using the chi-square test, the Fisher exact test and the Student’s t-test.
Results: Myometrial invasion > 50% (p < 0.001), cervical invasion (p = 0.001), lymphovascular space invasion (p = 0.003) and positive peritoneal cytology (p = 0.03) were significant predictors of retroperitoneal lymph node dissemination. Pelvic lymph node metastases were predictive of positive paraaortic lymph nodes (p < 0.001).
Discussion: The Mayo algorithm identified patients without pelvic or paraaortic nodal metastases with a 98.4% negative predictive value (61/62). Myometral invasion ≤ 50% and absence of cervical and lymphovascular invasion presented a negative predictive value of 98.8% (79/80).
Conclusion: Although the Mayo criteria predict a very low likelihood of retroperitoneal nodal metastases, the combination of myometral invasion ≤ 50% and absence of cervical or lymphovascular invasion would have safely avoided lymphadenectomy in a larger number of women.

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Author Biographies

Cecília Urzal, Departamento de Ginecologia e Obstetrícia. Centro Hospitalar Tondela-Viseu. Viseu. Portugal.

Rita Sousa, Serviço de Ginecologia. Instituto Português de Oncologia. Coimbra. Portugal.

Vítor Baltar, Serviço de Ginecologia. Instituto Português de Oncologia. Coimbra. Portugal.

Paulo Correia, Serviço de Ginecologia. Instituto Português de Oncologia. Coimbra. Portugal.

Eugénia Cruz, Serviço de Anatomia Patológica. Instituto Português de Oncologia. Coimbra. Portugal.

Daniel Pereira da Silva, Serviço de Ginecologia. Instituto Português de Oncologia. Coimbra. Portugal.

Published

2014-01-08

How to Cite

1.
Urzal C, Sousa R, Baltar V, Correia P, Cruz E, Pereira da Silva D. Factors Predictive of Retroperitoneal Lymph Node Metastasis in Endometrial Cancer. Acta Med Port [Internet]. 2014 Jan. 8 [cited 2024 Nov. 6];27(1):82-7. Available from: https://actamedicaportuguesa.com/revista/index.php/amp/article/view/4115