Tumor Burden of Non-bulky Metastatic Lymph Nodes in Endometrial Cancer: A Retrospective Cohort Study
Received: 12 Mar 2024 | Received in revised form: 22 May 2024
Accepted: 27 May 2024 | Available online: 31 May 2024Alper SEYHANa , İpek YILDIZ ÖZAYDINb , Merve KONALc , Özgür AKBAYIRc
aAdnan Menderes University Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Aydın, Türkiye
bKanuni Sultan Süleyman Training and Research Hospital, Clinic of Pathology, İstanbul, Türkiye
cProf. Dr. Cemil Taşcıoğlu State Hospital, Clinic of Obstetric and Gynecology, İstanbul, Türkiye
JCOG. 2024;34(2):67-72
DOI: 10.5336/jcog.2024-102726
Article Language: EN
Copyright Ⓒ 2024 by Türkiye Klinikleri. This is an open access article under the CC BY-NC-ND license (
http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: Evaluation of the diagnostic superiority of systematic lymphadenectomy in endometrial cancer cases in conditions of sentinel lymph node (SLN) dissection cannot be performed. Material and Methods: The file records of 853 patients with endometrial cancer were reviewed in the gynecological oncology clinic of Kanuni Sultan Süleyman Hospital between 2008 and 2020. Thirty nine endometrial cancer patients with lymph node involvement were selected to study. Pelvic and paraaortic lymph node counts, positive lymph node ratios, metastatic lymph node sizes and percentages of tumor infiltration in lymph nodes were defined. Clinicopathological variables, including the categorical data, were analyzed as a descriptive method. Results: Grossly suspicious lymph nodes were observed in 46.2% of the patients. While 54.4% of metastatic lymph nodes were <1 cm (non-palpable), 12% of them <5 mm. In 17.9% of patients, all dissected metastatic lymph nodes were <1 cm (non-palpable). Conclusion: In clinics that can not performed SLN procedure in endometrial cancer, extent of lymphadenectomy may vary as a systemic lymphadenectomy or selective palpable lymph node excision depends on surgeon preference and patient morbidity. With comprehensive lymphadenectomy, occult lymph node metastasis can be detected and adding adjuvant chemoradiotherapy allows the patients to be given better survival rates in Stage IIIc disease.
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