RT Journal Article SR Electronic T1 National Cancer Database Report of Lymphadenectomy Trends in Endometrial Cancer JF International Journal of Gynecologic Cancer JO Int J Gynecol Cancer FD BMJ Publishing Group Ltd SP 1408 OP 1415 DO 10.1097/IGC.0000000000001005 VO 27 IS 7 A1 Cripe, James A1 Handorf, Elizabeth A1 Brown, Jennifer A1 Jain, Angela A1 Rubin, Stephen A1 Mantia-Smaldone, Gina YR 2017 UL http://ijgc.bmj.com/content/27/7/1408.abstract AB Objectives Lymph node involvement has a significant impact on prognosis that may direct adjuvant therapy. The role of routine lymph node staging (LNS) is controversial given conflicting results in multiple studies. Our aims are to describe treatment patterns of LNS, identify factors impacting LNS, and quantify the contemporary trends.Methods/Materials The National Cancer Data Base was queried for patients undergoing hysterectomy for endometrioid and serous uterine carcinomas from 2003 to 2012. For endometrioid tumors, LNS was considered indicated if at least 1 of 4 criteria was met. Multivariate logistic regression and Cox proportional hazards model were used.Results A total of 161,683 patients were identified who received hysterectomy for 155,893 (96.4%) endometrioid and 5790 (3.6%) serous carcinomas. Receipt of LNS was significantly associated with greater than 50% myometrial invasion (odds ratio [OR], 1.63; 95% confidence interval [CI], 1.55–1.73), grades 3 to 4 (OR, 3.03; 95% CI, 2.83–3.25), and tumor size greater than 2 cm (OR, 1.17; 95% CI, 1.28–1.26). Of the 97,152 patients with endometrioid carcinoma who met criteria for comprehensive staging, 73,268 (75.4%) underwent LNS. Patients with endometrioid carcinoma meeting criteria for LNS were less likely to receive LNS if they were of African American race (OR, 0.92; 95% CI, 0.86–0.98), had Medicaid insurance status (OR, 0.75; 95% CI, 0.69–0.81), had Medicare insurance (OR, 0.82; 95% CI, 0.79–0.86), or received care at a community program (OR, 0.39; 95% CI, 0.33–0.46).Conclusions Nationally, most patients with greater than 50% myometrial invasion, grades 3 to 4, and/or tumor size greater than 2 cm receive LNS, but this was significantly impacted by insurance status, demographic characteristics, and facility location/type.