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Tumor Diameter and Lymphatic Dissemination

Gynecol Oncol; ePub 2016 Feb 26; Bauer, et al

Tumor diameter (TD) can help predict lymphatic dissemination (LD) and determine the need for lymphadenectomy following diagnosis of endometrioid endometrial cancer. This according to a study of 737 cancer patients diagnosed with stage I to III endometrioid endometrial cancer during 2003 to 2013 who underwent complete lymphadenectomy during hysterectomy, 68 of whom were node-positive. Researchers found:

• Overall, the most important LD predictors were TD50 and MI3rds (three-category form).

• The best candidate model (c-statistic, 0.84) suggested odds of LD were five times greater for TD >50 mm than ≤50 mm (OR=4.91) and six and ten times greater for MI >33% to ≤66% (OR=5.70) and >66% (OR=10.2), respectively, than ≤33%.

• Best model false-negative (0%) and positive (57.2%) rates demonstrated marked improvement over traditional risk-stratification false-negative (1.5%) and positive (76.2%) rates (c-statistic, 0.77).

• New risk model reduced the number of lymphadenectomies in low-risk patients.

Citation: Bauer CM, Greer DM, Kram JJF, Kamelle SA. Tumor diameter as a predictor of lymphatic dissemination in endometrioid endometrial cancer. [Published online ahead of print February 26, 2016]. Gynecol Oncol. doi:10.1016/j.ygyno.2016.02.017.