Background: One of the most important prognostic indicators in cancer is the lymph node dissection. Lymphadenectomy considered as a risk factor for deep vein thrombosis in patients with gynecological malignancy who underwent surgery. D-dimer was used to detect deep vein thrombosis, thus, it’s important to predict complications of post-operative Lymphadenectomy. Objective: To predict the  risk of deep venous thrombosis by used serum D-dimer and wells score after pelvic lymphadenectomy in gynecological cancer. Patients and method:  A cross sectional study conducted in Obstetrics and Gynecology/ ward in medical city, from 1st, January 2021 to 30th, Dec. 2021. A total number of 45 (22 endometrial, 12 ovarian and 11 cervical cancers).  Results: The mean±SD level of pre-operative D-dimer in patients with endometrial cancer was (423.2±123.9) while the mean±SD post-operative level was (987±125.1), the mean±SD level of pre-operative D-dimer in patients with ovarian cancer was (602±320.7) while the post-operative was (901.5± 412), mean±SD level of pre-operative D-dimer in patients with cervical cancer was (339±157) while the postoperative was (1214±327), and the mean±SD level of pre-operative D-dimer in all gynecological cancers was (541±167) while the post-operative was (1016±302). The mean±SD of wells score of those who are likely to developed DVT (n=7) in pre-operative was (2.3±0.02) while for those who are unlikely to develop deep vein thrombosis (n=38) was (2.03±0.4) with statistically significant difference (p=0.04) while highly significant difference found in pre- and post-operatively between the group of deep vein thrombosis (p˂0.001). Conclusion: Highly significant increase of post-operative D-dimer in all gynecological cancer patients.

Background: Lymph node metastasis (LNM) is an indicator of poor prognosis and requires adjuvant therapy in patient with endometrial cancer (EC). Lymphadenectomy is still the standard technique to assess the lymphatic spread of EC. However, the evaluation of the LNM preoperatively is an important factor in determining the outcome of patients with endometrial cancer. The Kanagawa Cancer Center (KCC) scoring system allows to identify patients risk of developing LNM based on tumor volume, myometrium invasion, histological type, and serumCA125 levels. Objective: To determine the predictive value of Kanagawa Cancer Centre (KCC) scoring system for lymph node metastasis in patients with endometrial cancer and compare it with Alhilli scoring. Patients and Methods: A prospective observational cross-sectional study carried out in the Department of Obstetrics and Gynecology / Baghdad Teaching Hospital, Baghdad, Iraq over a period of 20 months starting from December 2018 to August 2020. A total number of 52 patients with endometrial cancer were included. Preoperative assessment included histology and CA125. Results: The cut point of KCC score was 2, so KCC > 2 is predictive for lymph node involvement. The sensitivity, specificity, positive predictive value, and negative predictive value of KCC for lymph node involvement was found to be 100%, 95.5%, 80%, and 100%, respectively, with an accuracy of 96.2%. Lymph node involvement was seen significantly in patients with positive CA125 level, grade 3, nonendometrioid type, myometrium invasion ≥ 50%, and higher tumor volume. Regarding Al-hilli scoring system, the sensitivity, specificity, positive predictive value and negative predictive value was 100%, 40.9%, 23.5%, 100% respectively, with an accuracy of 50%. Conclusions: The KCC scoring system has a high accuracy for the prediction of lymph node involvement in patients with endometrial cancer with better accuracy than Al-hilli scoring.

Background: Endometrial thickening is a commonly measured parameter on routine gynecological ultrasound and magnetic resonance image. Recent studies show there is a relation between vitamin D (vit D), obesity and the degree of endometrial thickness. Aim of the study: To assess the relation between Vit (D) level and body mass index with post-menopausal endometrium thickness. Patients and Method: A cross sectional study that carried out in Department of Obstetrics and Gynecology at Baghdad Teaching Hospital from the first of Jan 2020 to the end of Dec 2020. A sample of 100 post-menopausal women participated in the study after fulfilling inclusion criteria (Menopause for 12 months, endometrial thickness ≥5 mm) for each patient we did for her pelvic ultrasound for endometrial thickness, measure Vit (D) level and body mass index. The patients were divided into: -patients who had post-menopausal bleeding we did endometrial biopsy and sent for histopathology depending on the result subdivided into group I with malignant changes and group II without malignant changes and group III = patients without Vaginal bleeding. Results: Endometrial thickness in group I was (16.15 ± 8.4) for group II was (14.3 ± 7) and for group III with significant difference found (P = 0.02), BMI were represented in group I (37.25 ± 5.15), (30.6 ± 8) for group II and (31.63 ± 7.47) in group III with no significant difference (P = 0.3), on logistic regression between these parameters and (ET) the result was significant with (vit D) with (p value = 0.02). Conclusion:Vitamin (D) level inversely related for post-menopausal endometrial thickness, postmenopausal bleeding and probability of endometrial cancer.