Analysis of Risk Factors for Lymphatic Metastasis in Endometrial Carcinoma and Utility of Three-Dimensional Magnetic Resonance Imaging in Gynecology

Tanase, Yasuhito; Takahama, Junko; Kawaguchi, Ryuji; Kobayashi, Hiroshi

doi:10.14740/wjon1106w

Cited by 5 publications

(5 citation statements)

References 20 publications

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“…Extrauterine risk factors include peritoneal cytology, nodal involvement (pelvic and paraaortic), intraperitoneal metastasis, and ovarian metastasis [9][10][11][12]. However, volume index, serum CA-125 levels, myometrial invasion, and grade are the most significant risk factors for lymph node metastasis [13].…”

Section: Introductionmentioning

confidence: 99%

Assessing Tumor Size by MRI and Pathology in Type I Endometrial Carcinoma to Predict Lymph Node Metastasis

Ali¹,

Mumtaz²,

Naqvi³

et al. 2022

Cureus

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IntroductionLymphatic spread is the most common route of spread of endometrial carcinoma, and the most frequently involved lymph nodes are those of the external iliac group. MRI is one of the best imaging tools for the preoperative evaluation of patients with endometrial carcinoma. The objective of the current study is to analyze the relationship between tumor size and lymph node metastasis in patients with type I endometrial carcinoma.

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Section: Introductionmentioning

confidence: 99%

Assessing Tumor Size by MRI and Pathology in Type I Endometrial Carcinoma to Predict Lymph Node Metastasis

Ali¹,

Mumtaz²,

Naqvi³

et al. 2022

Cureus

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“…The prognosis of type I EC patients is mostly good, while patients with type II EC are susceptible to distant metastasis, recurrence, and poor prognosis [18,19]. Risk factors for lymph node metastasis in EC have been previously reported [9,10]. However, few studies have investigated the risk factors for lymph node metastasis in type II EC.…”

Section: Discussionmentioning

confidence: 99%

“…Some well-known risk factors for pelvic lymph node metastasis in EC are the histologic type, volume index, and histologic grade. Of these, the volume index was found to be an independent risk factor for para-aortic lymph node metastasis [9,10]. Type II ECs account for approximately 20% of all ECs but are responsible for approximately 40% of EC deaths [11].…”

Section: Introductionmentioning

confidence: 99%

Risk factors of lymph node metastasis in patients with type II endometrial carcinoma: a retrospective signle-center study

2023

European Journal of Gynaecological Oncology

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In this study, we explored the risk factors for lymph node metastasis in patients with type II endometrial carcinoma (EC). Patients diagnosed with type II EC who underwent staged surgery and lymph node dissection were included. Univariate analysis was performed using a chi-square test for factors such as age, body mass index (BMI), menopausal status, histologic type, histologic grade, myometrial invasion, lymphatic vascular invasion (LVSI), tumor volume index, and para-aortic lymph node (PALN) or pelvic lymph node (PLN) metastasis. An analysis of multivariate factors was performed on the factors that were statistically significant in the univariate analysis. Pelvic lymph node metastasis was identified in 38 of the 184 patients with type II EC. Univariate analyses revealed that age ≥55 years, menopause, more than one-half myometrial invasion, and LVSI were risk factors for pelvic lymph node metastasis. Multivariate analysis indicated that myometrial invasion of more than one-half (hazard ratio (HR): 4.259) and LVSI (HR: 3.317) were independent risk factors for pelvic lymph node metastasis. Para-aortic lymph node metastasis was identified in 13 of the 184 patients with type II EC. Univariate analysis indicated that para-aortic lymph node metastasis was significantly associated with LVSI and pelvic lymph node metastases. Multivariate analysis suggested that pelvic lymph node metastasis (HR: 5.887) was an independent risk factor for para-aortic lymph node metastasis. LVSI and myometrial invasion depth >1/2 were significant predictors of pelvic lymph node metastasis in patients with type II EC. Patients with type II EC who have pelvic lymph node metastasis may be at risk of para-aortic lymph node metastasis.

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“…As far as the author knows, this study is the first to use 3D-MRI to evaluate preoperative staging. Some scholars use thirdparty software to construct a three-dimensional model of the uterus and tumor, but the model fails to visualize the anatomical position relationship, and then Cannot evaluate better and more accurately [8].…”

Section: Discussionmentioning

confidence: 99%

Preoperative Evaluation of 3D-MRI on the Depth of Myometrial Invasion of Endometrial Carcinoma: 3D Study of Endometrial Carcinoma

Fu¹,

Y²,

Xu³

et al. 2022

Clin. Exp. Obstet. Gynecol.

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Background: To evaluate the preoperative diagnostic efficacy of 3D-MRI for the depth of myometrial invasion of endometrial carcinoma. Methods: A total of 116 patients with endometrial carcinoma who had undergone pelvic MRI before surgery were included. Mimics 21.0 (Materialize Co., Belgium) software was used to reconstruct three-dimensional MRI models (3D-MRI). The tumor volume and surface area, uterine volume and surface area were measured, and the tumor volume ratio was calculated. TVR (Tumor Volume Ratio) = tumor volume/uterine volume, TAR (Tumor Area Ratio) = tumor surface area/uterine surface area. Postoperative pathology was used as the gold standard to compare the accuracy, sensitivity, specificity, negative predictive value, and positive predictive value of conventional MRI and 3D-MRI in preoperative assessment of endometrial carcinoma myometrial invasion. Results: The accuracy and specificity of 3D-MRI in the diagnosis of deep myometrial invasion were better than conventional MRI (p < 0.05). There was no statistically significant difference in tumor volume or surface area between stage IA and stage IB (p > 0.05), while TVR and TAR showed significant statistical differences (8.05 ± 0.66 vs. 19.12 ± 3.20, p < 0.01; 21.38 ± 1.04 vs. 35.15 ± 3.42, p < 0.01). Further analysis, the area under the ROC curve of TVR is 0.738, p < 0.01, and the best cut-off value is 13.59%; the area under the ROC curve of TAR is 0.770, p < 0.01, and the best cut-off value is 27.41%. Conclusions: Preoperative 3D-MRI can effectively assess the myometrial invasion of endometrial carcinoma.

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Analysis of Risk Factors for Lymphatic Metastasis in Endometrial Carcinoma and Utility of Three-Dimensional Magnetic Resonance Imaging in Gynecology

Cited by 5 publications

References 20 publications

Assessing Tumor Size by MRI and Pathology in Type I Endometrial Carcinoma to Predict Lymph Node Metastasis

Assessing Tumor Size by MRI and Pathology in Type I Endometrial Carcinoma to Predict Lymph Node Metastasis

Risk factors of lymph node metastasis in patients with type II endometrial carcinoma: a retrospective signle-center study

Preoperative Evaluation of 3D-MRI on the Depth of Myometrial Invasion of Endometrial Carcinoma: 3D Study of Endometrial Carcinoma

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