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Low-Volume Lymph Node Metastases in Endometrial Carcinoma.

Publication ,  Journal Article
Clinton, LK; Kondo, J; Carney, ME; Tauchi-Nishi, P; Terada, K; Shimizu, D
Published in: Int J Gynecol Cancer
July 2017

OBJECTIVE: The aim of this study was to determine the histopathologic characteristics of patients with endometrial carcinoma with low-volume metastases (micrometastases and isolated tumor cells) compared with macrometastases. METHODS: We performed a retrospective review of patients with endometrial carcinoma. RESULTS: Among 350 robotic-assisted hysterectomies for endometrial cancer, 187 (53%) underwent attempted sentinel lymph node (SLN) biopsy. At least 1 SLN was detected in 185, a 99% overall detection rate; 108 (58%) also had non-SLNs removed. Among 91 patients with SLNs and non-SLNs from the ipsilateral hemipelvis, both were negative in 74 (81%) and positive in 7 (8%), and 10 (11%) had a positive SLN with negative non-SLNs. Among 17 patients with SLNs and non-SLNs from the contralateral hemipelvis, both were negative in 12 (71%), both were positive in 3 (18%), and 2 patients (12%) had negative SLNs with contralateral positive non-SLNs. Among 79 patients with only a SLN dissection, 4 (5%) were positive; among 69 patients with only a non-SLN dissection, 14 (20%) had positive lymph nodes. Among 24 patients with metastatic SLNs, 9 (38%) had isolated tumor cells, 3 (13%) had micrometastases, and 12 (50%) had macrometastases. Among the 40 total patients with metastatic lymph nodes, low-volume metastases represented the largest metastatic deposit in one third of patients, all of which had SLN dissection. All 12 with low-volume metastases had endometrioid histology compared with less than half (46%) of those with macrometastases (P < 0.01). Grade 1 carcinoma was present in 7 (58%) of the patients with low-volume metastases compared with 4 (14%) of those with macrometastases (P < 0.01) Furthermore, significantly more patients with low-volume metastases versus macrometastases had less than 50% myometrial invasion (67% vs 4%, P < 0.001). CONCLUSIONS: Low-volume disease was present in one third of patients with nodal metastases, the largest metastatic deposit only in patients who had SLN dissection; these patients were significantly more likely to have grade 1 endometrioid carcinoma with less than 50% myometrial invasion, traditional "low-risk" features.

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Published In

Int J Gynecol Cancer

DOI

EISSN

1525-1438

Publication Date

July 2017

Volume

27

Issue

6

Start / End Page

1165 / 1170

Location

England

Related Subject Headings

  • Sentinel Lymph Node Biopsy
  • Robotic Surgical Procedures
  • Retrospective Studies
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Neoplasm Micrometastasis
  • Middle Aged
  • Lymphatic Metastasis
  • Lymph Nodes
  • Hysterectomy
 

Citation

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MLA
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Clinton, L. K., Kondo, J., Carney, M. E., Tauchi-Nishi, P., Terada, K., & Shimizu, D. (2017). Low-Volume Lymph Node Metastases in Endometrial Carcinoma. Int J Gynecol Cancer, 27(6), 1165–1170. https://doi.org/10.1097/IGC.0000000000001016
Clinton, Lani K., Jordan Kondo, Michael E. Carney, Pamela Tauchi-Nishi, Keith Terada, and David Shimizu. “Low-Volume Lymph Node Metastases in Endometrial Carcinoma.Int J Gynecol Cancer 27, no. 6 (July 2017): 1165–70. https://doi.org/10.1097/IGC.0000000000001016.
Clinton LK, Kondo J, Carney ME, Tauchi-Nishi P, Terada K, Shimizu D. Low-Volume Lymph Node Metastases in Endometrial Carcinoma. Int J Gynecol Cancer. 2017 Jul;27(6):1165–70.
Clinton, Lani K., et al. “Low-Volume Lymph Node Metastases in Endometrial Carcinoma.Int J Gynecol Cancer, vol. 27, no. 6, July 2017, pp. 1165–70. Pubmed, doi:10.1097/IGC.0000000000001016.
Clinton LK, Kondo J, Carney ME, Tauchi-Nishi P, Terada K, Shimizu D. Low-Volume Lymph Node Metastases in Endometrial Carcinoma. Int J Gynecol Cancer. 2017 Jul;27(6):1165–1170.
Journal cover image

Published In

Int J Gynecol Cancer

DOI

EISSN

1525-1438

Publication Date

July 2017

Volume

27

Issue

6

Start / End Page

1165 / 1170

Location

England

Related Subject Headings

  • Sentinel Lymph Node Biopsy
  • Robotic Surgical Procedures
  • Retrospective Studies
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Neoplasm Micrometastasis
  • Middle Aged
  • Lymphatic Metastasis
  • Lymph Nodes
  • Hysterectomy