Related Experiment Video
Updated: Jun 2, 2026
An Orthotopic Endometrial Cancer Model with Retroperitoneal Lymphadenopathy Made From In Vivo Propagated and Cultured VX2 Cells
Published on: September 12, 2019
Lymph node counts in endometrial cancer: expectations versus reality.
Elizabeth D Euscher1, Roland Bassett, Anais Malpica
1Department of Pathology, University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA. edeusche@mdanderson.org
Microscopic examination of residual adipose tissue after endometrial cancer lymph node dissection does not increase reported lymph node counts or detect additional positive nodes. Standard processing adequately reflects lymph node yield, suggesting current dissection adequacy criteria may need review.
Area of Science:
- Gynecologic Oncology
- Pathology
- Surgical Oncology
Background:
- Adequate lymph node (LN) counts are crucial for endometrial carcinoma (CA) staging.
- Surgeons have expectations for pelvic (PLN) and para-aortic (PALN) lymph node yields.
- Discrepancies between expected and reported LN counts present a clinical challenge.
Purpose of the Study:
- To determine if microscopic examination of residual adipose tissue (AT) impacts LN counts in endometrial CA staging.
- To assess if factors like surgical approach, surgeon, or patient characteristics influence LN yield.
- To evaluate the contribution of small LNs missed during gross examination.
Main Methods:
- Retrospective review of LN dissections from endometrial CA hysterectomies (2006-present).
- Evaluation of residual AT for additional LNs via hematoxylin and eosin staining.
- Analysis of LN counts in relation to surgical procedure, surgeon, CA subtype, myometrial invasion, and BMI.
Main Results:
- Microscopic review of residual AT yielded additional LNs in 64% of cases (median 2 PLNs, 3 PALNs).
- No significant association found between submitting residual AT and overall PLN or PALN counts.
- Metastatic CA was never found exclusively in the additionally identified LNs.
- Laparoscopic and robotic lymphadenectomy yielded more PALNs than open hysterectomy.
Conclusions:
- Standard processing of lymphadenectomy specimens adequately reflects LN yield in endometrial CA.
- Microscopic examination of residual AT does not significantly increase reported LN counts or detect positive LNs.
- Further research is needed to define optimal LN counts for adequate lymphadenectomy in endometrial CA.
