Abstract

Lymph node metastasis (LNM) represents a key determinant of prognosis in endometrial cancer, with a direct impact on disease staging and decisions regarding adjuvant therapy. Although endometrioid-type endometrial carcinoma (ECC) generally has a favorable prognosis, lymphatic spread may occur even in the early stages. The present study aimed to identify clinicopathologic variables independently associated with pelvic lymph node involvement among patients with EEC who underwent comprehensive lymphadenectomy. The retrospective analysis included 478 women with histologically verified EEC who underwent primary surgical staging with systematic pelvic lymphadenectomy. Univariate and multivariate logistic regression analyses were performed to identify the risk factors associated with pelvic LNM. Among the study population, 49 patients (10.2%) had pelvic LNM, while 429 (89.8%) were node-negative. Serum CA125 levels (34.1 vs. 19.5 U/mL), tumor diameters (4.6 vs. 3.5 cm), grade 3 rate (32.7% vs. 17.7%), deep myometrial invasion rate (61.2% vs. 38%), lymphovascular space invasion (LVSI) rate (59.2% vs. 22.4%), and cervical stromal invasion rate (34.7% vs. 9.1%) were significantly higher in those with nodal metastases. Multivariate analysis identified LVSI (HR=4.04), cervical stromal invasion (HR=3.53), tumor size (HR=1.06), and grade 3 histology (HR=1.39) as independent predictors of pelvic nodal metastasis (p

Key words: Endometrial carcinoma, Nodal metastasis, lymphovascular space invasion, Grade, Cervical stromal involvement