A preoperative risk-scoring system to predict lymph node metastasis in endometrial cancer and stratify patients for lymphadenectomy

Imai, Kazuaki; Kato, Hiroyuki; Katayama, Kazuhisa; Nakanishi, Kazuhiro; Kawano, Aiko; Iura, Ayaka; Konnai, Katsuyuki; Onose, Ryo; Hirahara, Fumiki; Miyagi, Etsuko

doi:10.1016/j.ygyno.2016.06.004

Cited by 34 publications

(27 citation statements)

References 25 publications

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“…The major challenge is in distinguishing the features that comprise ‘low-‘, ‘intermediate-‘, and ‘high-risk’ disease in ECs. Multiple different risk predictive clinical models have been developed to guide treatment [14, 37, 40–48]. These have evolved with new FIGO staging and through interpretation of large clinical trials, however all incorporate the key pathological parameters of histotype, grade, and stage.…”

Section: Endometrial Classification By Histomorphology and Current Symentioning

confidence: 99%

New classification of endometrial cancers: the development and potential applications of genomic-based classification in research and clinical care

Talhouk

McAlpine

2016

gynaecol oncol res pract

166

157

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Endometrial carcinoma (EC) is the fourth most common cancer in women in the developed world. Classification of ECs by histomorphologic criteria has limited reproducibility and better tools are needed to distinguish these tumors and enable a subtype-specific approach to research and clinical care. Based on the Cancer Genome Atlas, two research teams have developed pragmatic molecular classifiers that identify four prognostically distinct molecular subgroups. These methods can be applied to diagnostic specimens (e.g., endometrial biopsy) with the potential to completely change the current risk stratification systems and enable earlier informed decision making. The evolution of genomic classification in ECs is shared herein, as well as potential applications and discussion of the essential research still needed in order to optimally integrate molecular classification in to current standard of care.

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Section: Endometrial Classification By Histomorphology and Current Symentioning

confidence: 99%

New classification of endometrial cancers: the development and potential applications of genomic-based classification in research and clinical care

Talhouk

McAlpine

2016

gynaecol oncol res pract

166

157

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“…13,17,20 Recently, Imai et al 13 performed a retrospective review of the medical records of 653 patients with endometrial cancer. They classified the patients based on the KCC score and found that there was no difference in survival between patients with KCC score 0 who were or were not treated with lymphadenectomy.…”

Section: Discussionmentioning

confidence: 99%

“…All the patients were evaluated preoperatively using the KCC scoring system. 13 The scoring system includes volume index, myometrium invasion, tumor grade/histology, and serum CA125 level. Volume index was defined as the product of the maximum longitudinal diameter along the uterine axis, the maximum anteroposterior diameter (thickness) in a sagittal section image, and the maximum horizontal diameter in a horizontal section image.…”

Section: Study Protocolmentioning

confidence: 99%

“…14,16,17 Another model is the Kanagawa Cancer Center (KCC), which takes into consideration previously mentioned factors to predict the need for lymphadenectomy in patients with endometrial cancer. 13,18 All these series are based on institutional experience and special patients' ethnic groups. In addition, there is still no international consensus regarding a standard scoring system to predict the need for lymphadenectomy in patients with endometrial cancer.…”

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confidence: 99%

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Predictive Value of Kanagawa Cancer Center Scoring System for Lymph Node Metastasis and Need for Lymphadenectomy in Patients With Endometrial Cancer: A Validation Study

Momtahan¹,

Hosseini²,

Robati³

et al. 2018

Int J Gynecol Cancer

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“…Some studies suggest less extensive surgery for lowrisk patients, reserving para aortic lymphadenectomy for high-risk patients (4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

Accuracy of Imaging in Preoperative Local Staging of Endometrial Cancer: Could Imaging Predict Low Risk Patients?

Rahmani¹,

Heydari²,

Mousavi³

et al. 2017

International Journal of Women’s Health and Reproduction Scienc

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Objectives: In this study we aimed to evaluate diagnostic accuracy of magnetic resonance imaging (MRI) and transvaginal sonography (TVS) in identifying the depth of myometrial invasion and cervical involvement and also their relationship with the uterine arteries resistance index (RI) and pulsatility index (PI) in endometrial carcinoma. Materials and Methods: We performed a prospective study on 45 women with histologically confirmed diagnosis of endometrial carcinoma. The study was performed from October 2009 to December 2012. All the patients were evaluated by 3T MRI and TVS and transvaginal color Doppler sonography of uterine arteries. All the patients underwent hysterectomy and the result of imaging and pathologic studies were compared. Results: Mean age was 54.5 ± 10.8 years (33 to 77 years), mean gravid was 3.93 ± 2.8 and the mean parity was 3.9 ± 2.5. The pathology results indicated 29 patients (64.4%) in stage IA and 16 patients (35.6%) in stage IB. Mean endometrial thickness in stage IA patients was 18.4±14.4 mm and in stage IB patients was 38.5±11.5 mm. TVS also showed positive predictive value (PPV) of 76.5%, negative predictive value (NPV) of 88.9%, sensitivity of 81.3%, specificity of 85.7%, and accuracy of 84.1% for assessment of the depth of myometrial invasion in endometrial carcinoma. We found PPV of 86.7%, NPV of 92.3%, sensitivity of 86.7%, specificity of 92.3%, and accuracy of 90.2% for MRI study. Conclusions: TVS can evaluate the depth of myometrial invasion with an acceptable accuracy when MRI is not available or costeffective, or when MRI is contraindicated. Both preoperative MRI and TVS can predict low risk patients (less than 50% of myometrial invasion) accurately; thereby avoiding lymphadenectomy in these patients.

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A preoperative risk-scoring system to predict lymph node metastasis in endometrial cancer and stratify patients for lymphadenectomy

Cited by 34 publications

References 25 publications

New classification of endometrial cancers: the development and potential applications of genomic-based classification in research and clinical care

New classification of endometrial cancers: the development and potential applications of genomic-based classification in research and clinical care

Predictive Value of Kanagawa Cancer Center Scoring System for Lymph Node Metastasis and Need for Lymphadenectomy in Patients With Endometrial Cancer: A Validation Study

Accuracy of Imaging in Preoperative Local Staging of Endometrial Cancer: Could Imaging Predict Low Risk Patients?

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