P. Benedettipanici et al., ANATOMICAL AND PATHOLOGICAL-STUDY OF RETROPERITONEAL NODES IN ENDOMETRIAL CANCER, International journal of gynecological cancer, 8(4), 1998, pp. 322-327
To assess the patterns of lymphatic spread in endometrial carcinoma, d
ata from 91 endometrial cancer patients (surgical FIGO stage I: 59; II
: 12; III-IV: 20) who underwent systematic pelvic and aortic lymphaden
ectomy were analyzed. The median number of nodes removed was 27 aortic
(range 15-57) and 31 pelvic (range 20-68) nodes. Positive nodes were
found in 16 patients (18%), seven having pelvic, one aortic, and eight
both pelvic and aortic metastasis. The median number of positive node
s was three (range 1-29) aortic and two (range 1-18) pelvic nodes. Iso
lated pelvic node metastasis was observed in seven patients and aortic
metastasis in one patient. Pre-paracaval, pre-paraortic and intercavo
aortic, with superficial obturator, external iliac and common iliac we
re the node groups most frequently involved. These nodes may be consid
ered primarily invaded by the tumor. The higher prevalence of pelvic w
ith respect: to aortic metastasis, and the low risk of isolated aortic
spread, suggest that endometrial cancer spreads preferentially to the
pelvic area. Multivariate analysis showed that depth of myoinvasion a
nd adnexal metastasis were independent factors predicting the risk of
lymphatic spread. The risk of aortic spread was also predicted by the
pelvic node status. These data may be useful for tailoring lymphadenec
tomy.