Introduction/Background To analyze the role of tumor size in the decision of lymph node sampling (dissection) in early-stage endometrial cancer.

Methodology In our study, 1357 patients who were operated on with the diagnosis of endometrium cancer at Hacettepe University Medical Faculty Hospital between January 2001 and December 2020 were retrospectively screened. 371 patients with grade 1–2 endometrioid adenocarcinomas, with less than 1/2 myometrial invasion at the intraoperative pathology consultation (frozen) and no cervical or adnexal involvement, were included in the study analysis. Patients with extrauterine diseases were excluded.The patients were divided into two groups based on tumor size: >2 cm (Group A) and ≤2 cm (Group B). The pathological results of the pelvic and paraaortic lymph node samplings are compared.

Results The median age of the 371 patients who are included in the study is 56 (min: 21-max: 81). There are 223 (60.1%) patients in group A and 148 patients in group B.

Pelvic lymph node dissection is performed in 71.1% of the patients in Group A, and para-aortic lymph node dissection is performed in 44.4%.

Pelvic lymph node dissection is performed in 37.8% of the patients in group B, and para-aortic lymph node dissection is performed in 33.1%.

Metastasis is detected in 3% (6/160)of patients who underwent pelvic lymph node dissection in group A; at the same time, metastasis is found in paraaortic lymph nodes in 3% (3/99)of same patients.

There is no metastasis detected in pelvic and paraaortic lymph node samples in group B patients. All of the patients with metastases have tumors larger than 2 cm; on the other hand, no lymphatic metastasis is found in the presence of tumors less than 2 cm (p = 0.044).

Conclusion In our study, the presence of a tumor greater than 2 cm is associated with the pelvic and para-aortic lymph node metastasis.

Disclosures The authors have no conflict of interest related this research