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Endometrial Cancer - Predicting Lymph Node Metastases

Purpose: To predict the chances of lymph node metastases in a woman with Stage I or II endometrial cancer using the nomogram of Bendifallah et al.

Description

Bendifallah et al reported a nomogram for predicting lymph node metastases in a woman with apparent Stage I or II endometrial cancer. These can help to identify a woman who may benefit from more aggressive management. The authors are from multiple hospitals in France.


Patient selection: woman with apparent Stage I or II endometrial cancer

 

Parameters:

(1) age in years, from 10 to 100 years

(2) race

(3) histologic type of cancer

(4) histologic grade

(5) depth of invasion

 

points for age =

= 34 - (0.34 * (age))

 

Parameter

Finding

Points

race

Caucasian

0

 

Black

4.4

 

other

8.1

histologic type

adenocarcinoma

0

 

carcinosarcoma

7.7

 

clear cell

16.1

 

papillary serous

28.5

grade

Grade I (well-differentiated)

0

 

Grade II

12.8

 

Grade III (poorly differentiated)

26.5

depth of invasion

in situ

0

 

myometrial invasion, < 50%

47.6

 

myometrial invasion, > 50%

88.9

 

invasion of cervical stroma

100

 

total score =

= SUM(points for all 5 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 193

• The higher the score the greater the risk of lymph node metastases.

 

Score

Percent with Lymph Node Metastases

< 38.4

< 1%

38.4 to 82.8

(0.09 * (points)) - 2.45

82.8 to 138

(0.005368 * ((points)^2)) - (0.7395 * (points)) + 29.47

138 to 184

(0.8499 * (points)) - 86.55

> 184

> 70%

 


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Specialty

Objective

ICD-10