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Model of Todo et al for Predicting Lymph Node Metastases in a Woman with Endometrial Adenocarcinoma Based on Preoperative Risk Factors

Purpose: To predict the chances of pelvic and para-aortic lymph node metastases in a woman with endometrial adenocarcinoma based on the model of Todo et al.

Description

Todo et al developed a model for predicting lymph node metastasis to pelvic and para-aortic lymph nodes based on preoperative findings. These can help identify patients who have a low risk of nodal metastasis. The authors are from Hokkaido University in Sapporo, Japan.


Parameters:

(1) volume index of the tumor on MRI

(2) serum CA125 concentration (Fujirebio Diagnostics, Malvern, Pennsylvania)

(3) age in years

(4) histologic type (serous vs nonserous)

(5) histologic grade (well-differentiated = G1; moderately differentiated = G2; poorly differentiated = G3)

 

volume index =

= (length in cm) * (lateral width in cm) * (depth in cm)

 

Predictions:

(1) metastasis to pelvic lymph nodes

(2) metastasis to para-aortic lymph nodes

 

CA125

Volume Index

Grade

Percent with Metastasis in Pelvic Nodes

low

< 25

G1 or G2

4%

low

< 25

G3 or serous

14%

low

>= 25

G1 or G2

8%

low

>= 25

G3 or serous

20%

high

< 25

G1 or G2

4%

high

< 25

G3 or serous

50%

high

>= 25

G1 or G2

39%

high

>= 25

G3 or serous

67%

 

where:

• Low CA125: < 70 U/mL if < 50 years old or < 28 U/mL if >= 50 years old.

• High CA125: >= 70 U/mL if < 50 years old or >= 28 U/mL if >= 50 years old.

 

CA125

Volume Index

Percent with Metastasis to Para-Aortic Nodes

low

< 40

1%

low

>= 40

14%

high

< 40

7%

high

>= 40

43%

 

where:

• Low CA125: < 90 if < 50 years old or < 30 if >= 50 years old.

• High CA125: >= 90 if < 50 years old or >= 30 if >= 50 years old.

 

Limitations:

• The normal reference range for the CA125 assay was not given.

• The volume index assumes a rectangular shape for the tumor.


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Specialty

Objective

ICD-10