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[Pelvic lymph node metastasis in endometrial cancer]
N Takeshima1, S Umezawa, Y Shimizu
1Department of Gynecology, Cancer Institute Hospital, Tokyo.
Nihon Sanka Fujinka Gakkai Zasshi
|September 1, 1994
Summary
Pelvic lymph node metastasis in early endometrial cancer is linked to higher relapse rates. Identifying these metastatic sites through pelvic lymphadenectomy helps manage high-risk patients.
Area of Science:
- Gynecologic Oncology
- Surgical Pathology
Context:
- Endometrial cancer staging and treatment involve assessing lymph node involvement.
- Pelvic lymphadenectomy is a key component in the surgical management of endometrial cancer.
Purpose:
- To analyze factors associated with pelvic lymph node metastasis in stage I endometrial cancer.
- To evaluate the impact of lymph node metastasis on relapse rates and identify optimal adjuvant therapies.
Summary:
- In 393 stage I endometrial cancer cases, 8.4% had pelvic lymph node metastasis, with a 12.5% overall relapse rate.
- Significant factors for metastasis included myometrial invasion, tumor size, vessel permeation, cervical involvement, peritoneal cytology, and adnexal metastasis.
- Internal iliac nodes were most common in single-node metastasis, while external iliac nodes were most common overall. Relapse rates increased with the number of metastatic nodes, reaching 70% with three or more.
- Cases with lymph node metastasis had a 54.5% relapse rate, predominantly distant recurrence, compared to 8.6% without metastasis.
Impact:
- Pelvic lymphadenectomy is crucial for identifying high-risk patients and potentially reducing recurrence.
- Adjuvant cytotoxic chemotherapy may be more suitable for patients with confirmed lymph node metastasis.