Retroperitoneal lymph node metastases in Stage I carcinoma of the endometrium: correlation with risk factors

The present study was undertaken in patients with Stage I carcinoma of the endometrium to correlate risk factors and the prevalence of retroperitoneal lymph node metastases. From January 1975 to April 1983, 202 patients with Stage I disease had initial therapy at the Long Island Jewish-Hillside Medical Center, New Hyde Park, New York. Among these patients, 74 who had total abdominal hysterectomy, bilateral salpingo-oophorectomy, and selective lymph node biopsy without preoperative radiation were included in the study. Results indicate that risk factors associated with nodal metastasis were Grade 3 tumor (42.1%), papillary adenocarcinoma (28.6%), deep myometrial invasion (42.9%), surface extent of tumor growth greater than 1/3 of the endometrial cavity (31.8%), and a diffuse pattern of tumor growth (17.2%). In Stage 1 endometrial cancer with any of the above 5 risk factors, it is urged that a selective biopsy of para-aortic and pelvic nodes during hysterectomy should be performed.