Kang et al identified factors identifying a woman at risk for lymph node metastases from an endometrial adenocarcinoma. These can be determined on preoperative imaging and laboratory studies. The authors are from multiple university and cancer centers in Korea,belonging to the Korean Gynecologic Oncology Group..
Patient selection: endometrial adenocarcinoma prior to definitive resection
Parameters associated with lymph node metastases in the multivariate analysis:
(1) myometrial invasion on MRI
(2) extension beyond the uterine corpus on MRI
(3) enlargement of pelvic lymph nodes on MRI
(4) serum CA-125 in IU/mL by radioimmunoassay
|
Parameter |
Finding |
Points |
|
invasion into outer half of myometrium (> 50% of wall) |
absent |
0 |
|
|
present |
1 |
|
extension beyond uterine corpus |
absent |
0 |
|
|
present |
1 |
|
enlargement of pelvic lymph nodes |
absent |
0 |
|
|
present |
1 |
|
serum CA-125 |
<= 35 IU/mL |
0 |
|
|
> 35 IU/mL |
1 |
where:
• The coefficients for the multivariate analysis are given in the paper and Appendix but the constant is not given.
• The coefficient for each risk factor ranges from 1.07 to 1.43.
• Myometrial invasion and extension beyond the uterine corpus are treated as separate variables.
total number of risk factors =
= SUM(points for all 4 parameters)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 4
• The risk of lymph node metastases increases with the number of risk factors.
Limitations:
• The method for serum CA-125 analysis should show comparable performance.
Purpose: To identify a woman at risk for lymph node metastases from an endometrial adenocarcinoma based on the study of Kang et al.
Specialty: Hematology Oncology, Surgery, general, Obstetrics & Gynecology
Objective: risk factors
ICD-10: C54.1,
