Predictors for lymph nodes involvement in low risk endometrial cancer
| Autor: | Richard G. Moore, Abdul Saied Calvino, Steven T. Katz, Andrew P. Katz, Yfat Kadan |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Oncology medicine.medical_specialty Multivariate analysis medicine.medical_treatment Adenocarcinoma Body Mass Index 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine medicine Carcinoma Humans Risk factor Lymph node Aged Neoplasm Staging Retrospective Studies Aged 80 and over Univariate analysis 030219 obstetrics & reproductive medicine Hysterectomy business.industry Endometrial cancer Age Factors Obstetrics and Gynecology Middle Aged medicine.disease Endometrial Neoplasms medicine.anatomical_structure CA-125 Antigen Lymphatic Metastasis 030220 oncology & carcinogenesis Regression Analysis Female Lymph Nodes Lymph business |
| Zdroj: | Journal of Obstetrics and Gynaecology. 37:514-518 |
| ISSN: | 1364-6893 0144-3615 |
| Popis: | Neutrophil-lymphocyte ratio (NLR) and BMI were examined as pre-operative predictors for lymph node metastases in patients with low-risk endometrial cancer. The study was a retrospective analysis of 534 endometrial cancer patients that underwent hysterectomy and lymph node dissection. Included subjects had a preoperative diagnosis of a grade 1 or 2 endometrioid carcinoma and no macroscopic extrauterine disease. We compared node-negative to node-positive patients to identify correlates of node-positive disease. The node-positive group presented with lower BMI than the node-negative group, 31.5 and 34.4, respectively (p = .03). The mean NLR was higher in the node-positive group 3.4 vs 2.9 (p = .08), showing a trend towards significance on univariate analysis. On multivariate analysis, lower BMI was found to be an independent predictor for nodal metastasis. Our data suggest that lower BMI is a risk factor for lymph nodes involvement in low-risk endometrial cancer. Impact statement Most endometrial cancer patients have low-risk disease with low risk for lymph nodes metastasis. In order to reduce the number of patients that will undergo unnecessary lymph node dissection, different types of preoperative predictors for lymph node involvement were studied. CA 125 and different imaging modalities were found as useful predictors for more advanced disease. Less studied predictors are the systemic inflammatory response markers and patient's BMI. This study suggests that lower BMI is a risk factor for lymph node involvement in low-risk endometrial cancer. The neutrophil to lymphocyte ratio was close to significance as a predictor for lymph node involvement. In practice, physicians might favour comprehensive lymph node dissection when there is a doubt regarding the procedure but the patient is lean. The study's conclusion can be utilised for triaging patients to general gynaecologist vs gynaecologic oncologist. Further research should focus on combining predictors such as age, BMI, NLR, CA 125 and imaging to better predict lymph nodes involvement in low-risk endometrial cancer. |
| Databáze: | OpenAIRE |
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