Prat listed risk factors associated with lymph node metastases in a woman with endometrial carcinoma. These are modified from factors listed by Boronow et al. These can help identify a woman who should have lymph nodes sample at surgery.
Parameters:
(1) histologic grade
(2) histologic type
(3) depth of myometrial invasion (none/in situ, inner third, middle third, outer third)
(4) vascular invasion
(5) occult spread to cervix and/or adnexae
|
Parameter |
Finding |
Points |
|
grade and depth of invasion |
G1 and in situ |
0 |
|
|
G1 and inner third |
0 |
|
|
G1 and middle third |
0 |
|
|
G1 and outer third |
1 |
|
|
G2 and in situ |
0 |
|
|
G2 and inner third |
0 |
|
|
G2 and middle third |
1 |
|
|
G2 and outer third |
1 |
|
|
G3 and in situ |
0 |
|
|
G3 and inner third |
1 |
|
|
G3 and middle third |
1 |
|
|
G3 and outer third |
1 |
|
histologic type |
endometrioid |
0 |
|
|
serous |
1 |
|
|
clear cell |
1 |
|
vascular invasion |
none |
0 |
|
|
present |
1 |
|
occult spread |
none |
0 |
|
|
present |
1 |
where:
• G1 = well-differentiated; G2 = moderately differentiated; G3 = poorly differentiated
total number of risk factors =
= SUM(points for all 4 measures)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 4
• A person with no risk factors would not need lymph node sampling.
• A person with one or more risk factors may benefit from staging with lymph node sampling, especially if there is occult spread, G3 tumor or non-endometrioid histology.
Limitations with scheme:
• The risk is not equal between all risk factors. For example, a G3 tumor in the outer third would have greater risk than a G1 in the outer third.
Specialty: Hematology Oncology, Surgery, general, Obstetrics & Gynecology
ICD-10: ,
