Analysis of risk factors for sentinel lymph node metastasis in patients with endometrial cancer

To investigate the risk factors of sentinel lymph node (SLN) metastasis in patients with endometrial carcinoma (EC), and to establish a risk nomogram model.

In this retrospective study, the clinical data of 79 EC patients who were treated in Zhumadian Central Hospital from January 2019 to January 2021 were analyzed. The patients were divided into SLN positive group and SLN negative group according to the occurrence of SLN metastasis. Univariate and multivariate analyses were performed to explore the factors affecting the occurrence of SLN metastasis in EC patients. The nomogram model predicting the risk of SLN metastasis in EC patients was constructed. The discrimination, accuracy and clinical benefit rate of the model were evaluated.

Multivariate analysis showed that body mass index (BMI) ≥ 24 kg/m², tumor diameter ≥ 2 cm, low differentiation, and cervical stromal involvement were risk factors for SLN metastasis in EC patients (P < 0.05). And the risk of SLN in EC patients increased with the increase in human epididymis protein 4 (HE4) level (P < 0.05). The constructed nomogram model was tested, and the area under the curve (AUC) of the model was 0.934 (95% CI: 0.878-0.979), the calibration curve obtained a Brier of 0.084. Decision curve results showed that 68 out of every 100 EC patients could benefit without compromising the interests of others, with a benefit rate of 68%.

The occurrence of SLN in EC patients is related to their personal general characteristics, pathological characteristics, tumor markers, and other multi-dimensional indicators. The medical staff can evaluate the SLN risk of EC patients by combining multiple indicators.