TUMOR STATUS OF LYMPH-NODES IN EARLY ENDOMETRIAL CANCER IN RELATION TO LYMPH-NODE SIZE

A retrospective analysis of 36 patients with metastatic nodes out of 2 09 consecutively managed patients with a clinically stage I endometria l cancer was carried out. Of the 1023 lymph nodes removed, 154 nodes w ere found to be metastatic. The mean number of the involved nodes was 4.27 (range: 1-29). Of the 154 positive nodes, 3 had nodal diameters l ess than or equal to 3 mm (1.9%), 84 had diameters of 4-10 mm (54.6%), 60 had diameters of 11-20 mm (39.0%) and 7 had diameters more than 20 mm (4.5%). With increasing lymph node size, the frequency of tumoral involvement varies from 1.0% in nodes less than or equal to 3 mm to 63 .6% in nodes bigger than 20 mm. In terms of patients, nine of them wer e found to have a single metastatic node ranging from 6 mm to 10 mm in diameter. In the remaining 27 patients with multiple metastatic nodes , the biggest nodes encountered were 6-10 mm in 4 (14.8%), 11-20 mm in 17 (62.9%) and more than 20 mm in 6 (22.2%) patients. Since mere samp ling of the lymphatic tissue directed particularly to the enlarged nod es may not show the true incidence of positive nodes, a complete lymph adenectomy is advocated in order to obviate an understaging problem.