PT - JOURNAL ARTICLE AU - Gokhan Boyraz AU - Mehmet Coskun Salman AU - Murat Gultekin AU - Derman Basaran AU - Murat Cagan AU - Nejat Ozgul AU - Kunter Yuce TI - Incidence of Lymph Node Metastasis in Surgically Staged FIGO IA G1/G2 Endometrial Cancer With a Tumor Size of More Than 2 cm AID - 10.1097/IGC.0000000000000919 DP - 2017 Mar 01 TA - International Journal of Gynecologic Cancer PG - 486--492 VI - 27 IP - 3 4099 - http://ijgc.bmj.com/content/27/3/486.short 4100 - http://ijgc.bmj.com/content/27/3/486.full SO - Int J Gynecol Cancer2017 Mar 01; 27 AB - Objective The study aims to investigate effect of tumor size on lymphatic spread in patients with low-risk endometrial cancer (EC).Methods This study included patients with EC who underwent staging surgery with systematic lymphadenectomy between 2002 and 2015 at the Hacettepe University Hospital. Patients with grade 1 or 2 endometrioid type tumor who had 50% or lower myometrial invasion were included. Patients who had no myometrial invasion or had uterine high-risk features (nonendometrioid histology, grade 3, and deep myometrial invasion) were excluded.Results The study group consisted of 191 patients, and the mean age of the patients was 57.8 years. Of these patients, 124 (64.9%) had tumor size of more than 2 cm and 67 (35.1%) had tumor size of 2 cm or less. Lymph node metastasis was detected in 12 (9.7%) of the 124 patients with tumor size of more than 2 cm. On the other hand, none of the 67 patients (0%) with tumor size of 2 cm or less was found to have lymphatic involvement. Of the factors analyzed for correlation with lymph node metastasis in patients with low-risk EC, the presence of lymphovascular space invasion (LVSI) and primary tumor size were found to be significant predictors of lymphatic spread in univariate analysis (P < 0.001 and P = 0.009, respectively). In multivariate analysis, tumor size (odds ratio, 6.86; 95% confidence interval, 1.007-infinite; P < 0.05) and LVSI (odds ratio, 14.261; 95% confidence interval, 3.4–59.6; P < 0.001) were 2 independent predictors associated with lymphatic involvement.Conclusions Our trial supports that tumor size of more than 2 cm and LVSI are 2 independent factors for lymph node metastasis in patients with low-risk EC. Both factors can be used together to select patients with traditional low-risk histologic features who would absolutely benefit from lymph node dissection.