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Low risk endometrial cancer: A study of pelvic lymph node metastasis
  1. M. Watanabe,
  2. Y. Aoki,
  3. H. Kase,
  4. K. Fujita and
  5. K. Tanaka
  1. Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Asahimachi dori Niigata, Japan
  1. Address correspondence and reprint requests to: Yoichi Aoki, MD, Department of Obstetrics and Gynecology, Niigata University Gradu- ate School of Medical and Dental Sciences, 1–757 Asahimachi dori Niigata 951–8510, Japan. E-mail: yoichi{at}


The aim of our study was to find preoperative or intraoperative pathologic indicators that would discriminate a subgroup of early corpus cancers that would not require lymphadenectomy. A retrospective review of the medical records of 107 patients with endometrioid adenocarcinoma, FIGO grade 1 or 2 tumor, myometrial invasion ≤50%, and no intraoperative evidence of macroscopic extrauterine spread was performed. Clinicopathologic risk factors were analyzed with Fisher ′s exact test with regards to pelvic lymph node metastasis. The median age of the patients was 54 years. Pelvic lymph node metastasis was observed in five of 107 patients (4.7%), where two patients with small tumors of 2 cm or less had positive pelvic lymph nodes. The presence of positive pelvic lymph nodes did not correlate with depth of invasion, histologic grade, cervical invasion, peritoneal cytology, menopausal status, preoperative serum CA125 level, or primary tumor diameter. Only lymphvascular space involvement (P < 0.0001) was significantly correlated to pelvic lymph node metastasis. We suggest that all patients with endometrial cancer who are taken to the operating room for primary therapy should be prepared to undergo extended surgical staging, except when clinical or operative factors increase patients' morbidity.

  • CA125
  • low-risk endometrial cancer
  • pelvic lymph node metastasis
  • pelvic lymphadenectomy
  • tumor diameter

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