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Pelvic Lymph Node Metastasis And Endometrial Cancer

All patients with endometrial cancer should be prepared to undergo extended surgical staging, urge researchers in Japan.

Only when clinical or operative factors increase a patient's morbidity should exceptions to this rule be made, suggest Dr M Watanabe and colleagues from the Niigata University Graduate School of Medical and Dental Sciences, Asahimachi dori Niigata.

These investigators investigated if there were any pre- or intraoperative pathologic indicators that might point to a subgroup of early corpus cancers that would not require lymphadenectomy. They reviewed the medical records of 107 patients, median age 54 years.

The patients had endometrioid adenocarcinoma, FIGO grade one or two tumour, myometrial invasion of 50% or less and no intraoperative evidence of macroscopic extrauterine spread.

Investigators analysed clinicopathologic risk factors via Fisher's exact test with respect to pelvic lymph node metastasis. They found pelvic lymph node metastasis in 5 of 107 patients (4.7%), where 2 patients with small tumours of 2 cm or less had positive pelvic lymph nodes.

Presence of positive pelvic lymph nodes did not correlate with depth of invasion, histologic grade, cervical invasion, peritoneal cytology, menopausal status, preoperative serum CA125 level or primary tumour diameter. Only lymphvascular space involvement was significantly correlated to pelvic lymph node metastasis.
Int J Gynecol Cancer 2003 Jan-Feb;13:1:38-41. "Low risk endometrial cancer: A study of pelvic lymph node metastasis"

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