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Introduction/Background To evaluate the clinical implication of preoperative tumor grade results in endometrial cancer with low-risk for lymph node metastasis. Methodology The medical records of 75 women with endometrial cancer were retrospectively reviewed. Women with (1) non-endometrioid type, (2) deep myometrial invasion on magnetic resonance imaging (MRI), (3) enlarged lymph node on MRI, (4) extension beyond the uterine corpus on MRI and (5) serum cancer antigen 125 (CA-125) level >35 IU/ml before surgery were excluded. Pattern of pelvic lymph node dissection (PLND) and clinical course by preoperative tumor grade were compared. Results Median age was 45 (range, 28–83) years and follow-up period was 35 (range, 1–126) months. Grade 1, grade 2-3 and unknown grade were respectively diagnosed in 50 (66.7%), 11 (14.7%) and 14 (18.6%) women before staging surgery by endometrial biopsy. After surgery, 30% of preoperative grade 1 was confirmed to non-grade 1, and 48.0% of preoperative non-grade 1 was confirmed to grade 1 (p=0.063). PLND was similarly performed between the preoperative grade 1 and non-grade 1 groups (44.0% vs. 36.0%, p=0.507). Lymph node metastasis was diagnosed in 1 women with preoperative grade 1 and 1 women with preoperative non-grade 1 (4.5% vs. 11.1%, p=0.503). There was no recurrence in women with preoperative non-grade 1 during follow-up period (0% vs. 6.0%, p=0.546). Conclusion Preoperative tumor grade results occasionally make it difficult to decide PLND omission in low-risk endometrial cancer, however, non-grade 1 tumor seems not to increase the lymph node metastasis and recurrence. Disclosure Nothing to disclose. |
