Lower uterine segment involvement as a predictor for lymph node spread in endometrial carcinoma

Area of Science:

• Gynecologic Oncology
• Surgical Pathology
• Cancer Research

Background:

• Lymph node metastasis is a critical prognostic factor in endometrial cancer.
• Predictive factors for lymph node spread include tumor grade, invasion depth, and vascular invasion.
• The role of lower uterine segment involvement in predicting lymph node spread requires further investigation.

Purpose of the Study:

• To determine if lower uterine segment involvement in endometrial carcinoma is associated with lymph node spread.
• To investigate the predictive value of lower uterine segment involvement for nodal metastasis in endometrial cancer.

Main Methods:

• Retrospective study of 299 patients diagnosed with endometrial cancer.
• Analysis of lower uterine segment involvement and its correlation with lymph node status.
• Univariate and multivariate logistic regression, Chi-square, and Fischer's Exact Test were employed.

Main Results:

• 58% of patients had lower uterine segment involvement.
• Patients with lower uterine segment involvement had significantly higher rates of positive lymph nodes (25% vs. 8%).
• Lower uterine segment involvement was a significant predictor of nodal spread in the endometrioid subtype on multivariate analysis.

Conclusions:

• Lower uterine segment involvement is a significant predictor of lymph node metastasis in endometrial carcinoma, especially for endometrioid histologies.
• Considering lower uterine segment tumor involvement may improve intraoperative staging and treatment planning for endometrial cancer.