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Preoperative predictors of endometrial carcinoma in patients undergoing hysterectomy for endometrial intraepithelial

Neçirvan Çağdaş Çaltek1, Hale Özer Çaltek2, Mahmut Yassa3

  • 1Gynecologic Oncology Surgery Clinic, Basakşehir Cam and Sakura City Hospital, Istanbul, 34480, Turkey. nccaltek@gmail.com.

BMC Cancer
|May 16, 2025
PubMed
Summary
This summary is machine-generated.

Preoperative predictors like age, BMI, and endometrial thickness can identify patients with endometrial intraepithelial neoplasia (EIN) who may have concurrent endometrial cancer (EC) and require lymph node dissection.

Keywords:
Endometrial cancerEndometrial intraepithelial neoplasiaEndometrial thicknessGynecologic oncologyLymph node dissection

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Area of Science:

  • Gynecologic Oncology
  • Surgical Pathology
  • Oncology

Background:

  • Endometrial intraepithelial neoplasia (EIN) surgery often reveals concurrent endometrial cancer (EC).
  • Lymph node dissection (LND) is sometimes necessary during surgery for EIN.
  • Preoperative identification of EC risk and need for LND is crucial.

Purpose of the Study:

  • To predict the presence of concurrent endometrial cancer (EC) in patients diagnosed with EIN.
  • To identify patients with EIN who may require lymph node dissection (LND) preoperatively.

Main Methods:

  • Retrospective analysis of 172 patients with EIN undergoing surgery.
  • Demographic, imaging, clinical, surgical, and pathology data were collected.
  • Statistical analyses included t-tests, Mann-Whitney U tests, odds ratios, and Fisher's exact test.

Main Results:

  • Of 172 patients, 71 (41.3%) had EC. Age ≥50, diabetes, and hypertension were associated with EC.
  • Age ≥50, BMI ≥35 kg/m², postmenopausal status, diabetes, hypertension, and endometrial thickness (ET) ≥14 mm predicted occult EC.
  • ET ≥14 mm increased EC likelihood fourfold (aOR: 4.06). 62% of EC patients met criteria for LND.

Conclusions:

  • Age ≥50, postmenopausal status, diabetes, hypertension, BMI ≥35 kg/m², and ET ≥14 mm are significant predictors of concurrent EC.
  • Patients with these risk factors should be referred to gynecologic oncology for potential lymph node assessment.
  • This includes consideration for lymphadenectomy or sentinel lymph node biopsy.