Article Text
PDF
Abstract
Introduction/Background Current clinical guidelines lack algorithms for surgical nodal staging of the aortic area in endometrial cancer (EC). Although isolated aortic involvement in EC is low, it is influenced by the overall risk of nodal metastasis in EC, which is itself low (<10%). In selected groups, the incidence of aortic involvement is higher, and in any case, it represents approximately the 25%. Moreover, more than half of the cases with pelvic nodal involvement also have aortic involvement, necessitating modification of irradiation fields in most centers, which is often underestimated with imaging techniques. The aim of this study is to create a predictive model of aortic involvement for performing GC based on preoperative risk factors.
Methodology Retrospectively, 376 women who underwent surgical intervention for EC at Donostia University Hospital between August 2014 and July 2022 were identified. Logistic regression was used to develop a prediction model for aortic lymph node involvement, considering the low frequency of such involvement in EC. A reduced number of variables were specified a priori to minimize overfitting and prediction errors while ensuring clinical applicability.
Results Among the 376 patients, 25 (6.65%) were found to have aortic lymph node metastasis. In the univariate analysis, all potential predictors were more prevalent among women with aortic lymph node involvement and exhibited statistically significant associations, except for non-endometrioid histology with tumour extension beyond the uterine corpus, which showed the strongest association with positive aortic lymph nodes. In the multivariable logistic regression model, this positive association persisted, but with greater uncertainty, so only extension beyond the uterine corpus retained its statistical significance.
Conclusion The nomogram developed in this study could be used to estimate the risk of aortic lymph node involvement in endometrial cancer and may be useful in decision-making regarding its management.
Disclosures No disclosures.