Introduction/Background Endometrial cancer is the most common malignancy of the female reproductive tract. Lymph node metastases are an important prognostic factor in endometrial cancer. Several prognostic factors have been shown to correlate with lymph node metastasis: depth of myometrial invasion, cervical infiltration, histologic grade of the tumor, tumor diameter, serous histology, lymphovascular invasion, and positive peritoneal cytology.

Methodology Finding the pathohistological parameters that will indicate with greater certainty the possibility of metastases in the lymph nodes, on the basis of which it will be evaluated whether such patients should undergo lymphadenectomy or not. A retrospective analysis of patients with endometrial cancer who underwent surgery at the Oncology Institute of Vojvodina (Clinic for Operative Oncology – Department of Gynecology) in the period from 2012 to 2018.The study included 120 patients who underwent hysterectomy with bilateral adnexectomy and pelvic lymphadenectomy.

Results Among patients who had lymph node metastases, there were statistically significant more patients (p <0.01) with endometrial cancer of histological type 2, with depth of myometrial invasion greater than 50%, cervical stroma infiltration, lymphovascular invasion, and positive peritoneal cytology.

Conclusion Histopathological parameters such as type 2 endometrial cancer, myometrial invasion depth greater than 50%, cervical stroma infiltration, lymphovascular invasion and positive peritoneal cytology increase the chances of lymph node metastases. Tumor size (> 2 cm) as well as histologic grade did not correlate with a higher incidence of lymph node metastases. In this study, both the parametrial infiltration and the number of lymph nodes removed have clinical significance, but not statistical significance.