Introduction/Background High-intermediate and high-risk endometrial cancer cases are associated with increased risk for lymph node invasion. Main objective of the present study was to report the overall rate of pelvic and paraaortic lymph node invasion in these cases.

Methodology A retrospective single-center study was observed regarding the period 2019–2022. In this study we included cases with high-intermediate and high-risk endometrial cancer cases in which full surgical staging with pelvic and para-aortic lymphadenectomy was performed, either open or laparoscopically. Epidemiological and histopathological characteristics of patients were recorded. Primary outcome was the rate of overall lymph node invasion as well as the rate of invasion in pelvic and para-aortic lymph nodes separately. Univariate regression analysis was also performed to identify histopathological parameters being significantly associated with risk for lymph node invasion

Results There were overall 22 cases identified during the period. Mean age of patients were 65.9 years, while final stage was assessed to be stage ≥ IIIA in 71.4% of cases (n=15). Overall rate of lymph node invasion was 59.1% (n=13), while relative rates for pelvic and para-aortic lymph nodes were 59.1% (13/22) and 50.0% relatively (11/22). Rates did not differ significantly between sub-groups of high-intermediate and high risk patients, ranging between 46.2% and 61.5%. LVSI was assessed to be independent factor of lymph node invasion (P=.03).

Conclusion High-intermediate and high risk endometrial cancer cases are associated with high rates of pelvic and para-aortic lymph node invasion. Surgical staging still remains the procedure of choice in this category of patients to identify lymph node metastasis and therafter tailor adjuvant treatment.