Predictors of lymphatic failure in endometrial cancer
- PMID: 11855884
- DOI: 10.1006/gyno.2001.6550
Predictors of lymphatic failure in endometrial cancer
Abstract
Objective: The aim of this study was to identify determinants of lymphatic failure in patients with endometrial cancer after definitive primary treatment.
Methods: We observed 142 relapses in endometrial cancer patients who had primary surgery at our institution during the decade before 1994. We defined lymphatic failure as a relapse occurring on the pelvic sidewall (PSW), para-aortic area (PAA), or other node-bearing area (i.e., groin, axilla, supraclavicular, mediastinal). Mean follow-up was 72.8 months.
Results: We observed 44 instances of lymphatic failure--6 on the PSW only, 16 in the PAA only, 12 concomitantly in the PAA and on the PSW, and 10 confined in other node-bearing areas. By univariate analysis, body mass index > or = 30 kg/m(2), para-aortic lymph node biopsy, cervical stromal invasion (CSI), positive adnexa, myometrial invasion >50%, primary tumor diameter >2 cm, positive peritoneal cytology, positive lymph nodes (pelvic and/or para-aortic), radiotherapy, grade 3 tumor, nonendometrioid histology, and lymph--vascular invasion (LVI) significantly (P < or = 0.05) correlated with lymphatic failure. However, on Cox regression analysis, only LVI (P < 0.01, relative risk [RR] = 4.27), nodal involvement (P = 0.02, RR = 3.43), and CSI (P = 0.049, RR = 2.26) were independent predictors of lymphatic failure. Moreover, lymph node metastases (P = 0.01, RR = 19.82) and CSI (P = 0.050, RR = 3.57) independently predicted failure on the PSW, and only lymph node involvement (P < 0.01, RR = 10.15) predicted relapse in the PAA.
Conclusion: LVI, positive lymph nodes, and CSI were the strongest predictors of lymphatic failure in endometrial cancer (31% of patients with at least one of the above three variables had a failure at 5 years). Patients with none of the above three factors had an extremely low (<1%) risk of lymphatic failure.
Similar articles
-
Lymph-vascular space invasion and number of positive para-aortic node groups predict survival in node-positive patients with endometrial cancer.Gynecol Oncol. 2005 Mar;96(3):651-7. doi: 10.1016/j.ygyno.2004.11.026. Gynecol Oncol. 2005. PMID: 15721407
-
Analysis of FIGO Stage IIIc endometrial cancer patients.Gynecol Oncol. 2001 May;81(2):273-8. doi: 10.1006/gyno.2001.6157. Gynecol Oncol. 2001. PMID: 11330962
-
Efficacy of systematic lymphadenectomy and adjuvant radiotherapy in node-positive endometrial cancer patients.Gynecol Oncol. 2006 May;101(2):200-8. doi: 10.1016/j.ygyno.2006.01.032. Epub 2006 Feb 28. Gynecol Oncol. 2006. PMID: 16510174
-
Stage IB endometrial cancer. Does lymphadenectomy replace adjuvant radiotherapy?Strahlenther Onkol. 2007 Nov;183(11):600-4. doi: 10.1007/s00066-007-1801-3. Strahlenther Onkol. 2007. PMID: 17960334 Review.
-
Sentinel lymph node as a new marker for therapeutic planning in breast cancer patients.J Surg Oncol. 2004 Mar;85(3):102-11. doi: 10.1002/jso.20022. J Surg Oncol. 2004. PMID: 14991881 Review.
Cited by
-
Development and Validation of a Nomogram Based on Metabolic Risk Score for Assessing Lymphovascular Space Invasion in Patients with Endometrial Cancer.Int J Environ Res Public Health. 2022 Nov 25;19(23):15654. doi: 10.3390/ijerph192315654. Int J Environ Res Public Health. 2022. PMID: 36497730 Free PMC article. Clinical Trial.
-
A detailed analysis of lymph node recurrence in endometrial carcinoma.Transl Cancer Res. 2022 Jul;11(7):2217-2224. doi: 10.21037/tcr-21-2588. Transl Cancer Res. 2022. PMID: 35966308 Free PMC article.
-
Prognostic Role of the Removed Vaginal Cuff and Its Correlation with L1CAM in Low-Risk Endometrial Adenocarcinoma.Cancers (Basel). 2021 Dec 22;14(1):34. doi: 10.3390/cancers14010034. Cancers (Basel). 2021. PMID: 35008194 Free PMC article.
-
Comparison of Different Lymph Node Staging Schemes for Predicting Survival Outcomes in Node-Positive Endometrioid Endometrial Cancer Patients.Front Med (Lausanne). 2021 Jul 9;8:688535. doi: 10.3389/fmed.2021.688535. eCollection 2021. Front Med (Lausanne). 2021. PMID: 34307415 Free PMC article.
-
A nomogram prediction model for lymph node metastasis in endometrial cancer patients.BMC Cancer. 2021 Jun 29;21(1):748. doi: 10.1186/s12885-021-08466-4. BMC Cancer. 2021. PMID: 34187416 Free PMC article.
Publication types
MeSH terms
Grants and funding
LinkOut - more resources
Full Text Sources
Medical