Objectives The role of lymphadenectomy in early-stage endometrial cancer is controversial as it is associated with intra-operative complications, and its therapeutic benefit is not established. Prediction of lymph nodal metastasis to perform selective lymph node dissection is desirable. This study was conducted to study the grade of the tumor obtained by endometrial biopsy specimen and depth of myometrial invasion assessed by imaging pre-operatively as predictors of lymph nodal metastasis in early endometrial cancers.

Methods This was a cross-sectional study where we studied 100 patients from August 2016 to May 2018. After Ethical Committee clearance, all patients diagnosed with early endometrial cancer in our hospital were included in the study after getting informed consent. Pre-operative tumor grade and depth of myometrial invasion were studied as predictors of lymph nodal metastasis.

Results The incidence of positive lymph node metastasis in our study was 18.6%. Both pre-operative tumor grade and depth of myometrial invasion were not significantly associated with lymph node metastasis. There was significant variation between pre-operative and post-operative tumor grade and depth of myometrial invasion. Among postoperative histopathological factors, only lymphovascular space invasion was significantly associated with lymph node metastasis.

Conclusions In our study, neither pre-operative nor postoperative grade of the tumor and depth of myometrial invasion were significantly associated with lymph node metastasis. There was considerable variation between pre-op and post-op grades of the tumor, making pre-op grade an unreliable factor in predicting lymph node metastasis in endometrial cancer. Among postoperative histopathological factors, only lymphovascular space invasion was significantly associated with lymph node metastasis.