Validation of an Endometrial Tumor Diameter Model for Risk Assessment in the Absence of Lymph Node Mapping.

Autor:	Riggs MJ; Department of Obstetrics and Gynecology, Brooke Army Medical Center, San Antonio, TX., Cox Bauer CM; Department of Obstetrics and Gynecology, Brooke Army Medical Center, San Antonio, TX.; Obstetrics and Gynecology, Aurora Sinai Medical Center, Milwaukee, WI., Miller CR; Department of Obstetrics and Gynecology, Brooke Army Medical Center, San Antonio, TX., Aden JK; Brooke Army Medical Center, San Antonio, TX., Kamelle SA; Gynecologic Oncology, Aurora St. Luke's Medical Center, Milwaukee, WI.
Jazyk:	angličtina
Zdroj:	Journal of patient-centered research and reviews [J Patient Cent Res Rev] 2020 Oct 23; Vol. 7 (4), pp. 323-328. Date of Electronic Publication: 2020 Oct 23 (Print Publication: 2020).
DOI:	10.17294/2330-0698.1768
Abstrakt:	Purpose: This study aimed to assess the optimal tumor diameter for predicting lymphatic metastasis and to determine intraoperatively the need for lymph node dissection in patients with endometrioid endometrial cancer. Methods: Military beneficiaries diagnosed with stage I-III endometrioid endometrial cancer during 2003-2016 who had at least 7 pelvic and/or paraaortic lymph nodes removed during the time of hysterectomy were studied. Tumor diameter was compared against the presence of positive nodes, using the prior models of 20 mm (ie, Mayo model) and 50 mm (ie, Milwaukee model), to determine the false-negative rate of each threshold. A separate analysis was completed to determine the optimal diameter for our population. Receiver operating characteristic curve analysis models of tumor diameter were evaluated for model fit and predictive power of lymph node involvement. Results: Of the 1224 patients with endometrioid endometrial cancer included, 13% (n=160) had positive lymph node involvement. Tumor sizes ranged from 1 mm to 100 mm. In contrast to Mayo and Milwaukee models (ie, Mayo, Milwaukee), the optimal tumor diameter independent of myometrial invasion and grade of tumor to predict lymph node metastasis was found to be 35 mm. Conclusions: Endometrioid endometrial cancer tumor diameter of 35 mm was found to be the optimal threshold for lymphadenectomy when the operating surgeon has no knowledge of tumor invasion. Competing Interests: Conflicts of Interest The authors have no conflicts to disclose. The views expressed herein are those of the authors and do not reflect the official policy or position of Brooke Army Medical Center, the U.S. Army Medical Department, the U.S. Army Office of the Surgeon General, the Department of the Army, the Department of the Air Force, the Department of Defense, or the U.S. Government. (© 2020 Aurora Health Care, Inc.)
Databáze:	MEDLINE
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