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Retrospective review of an intraoperative algorithm to predict lymph node metastasis in low-grade endometrial adenocarcinoma.

Publication ,  Journal Article
Convery, PA; Cantrell, LA; Di Santo, N; Broadwater, G; Modesitt, SC; Secord, AA; Havrilesky, LJ
Published in: Gynecol Oncol
October 2011

OBJECTIVE: To validate the Mayo algorithm to intraoperatively identify women with endometrial cancer in whom lymphadenectomy may be safely omitted. METHODS: A multi-center retrospective chart review 1977-2010 was completed using two independent institutional endometrial cancer databases. Eligibility criteria were grade 1 or 2 endometrial carcinoma, low-risk histology, and myometrial invasion ≤ 50% on intraoperative pathology consultation; patients were considered to satisfy the Mayo criteria if, in addition to these, tumor diameter on the final pathology report was ≤ 2 cm. Analysis of nodal metastases, recurrent disease, and progression-free survival (PFS) using the Kaplan-Meier method was performed. RESULTS: Six hundred and two patients met inclusion criteria for the study. Of 110 patients satisfying the Mayo algorithm with an adequate lymphadenectomy, 2 (1.8%) were diagnosed with lymph node metastasis and 4 (3.6%) subsequently developed recurrent disease. The Mayo algorithm identified with a 98.2% negative predictive value women who would not benefit from a lymphadenectomy. There was no significant difference in recurrence rate or PFS between women who underwent lymphadenectomy and those who did not when the Mayo algorithm was satisfied. CONCLUSIONS: The Mayo algorithm intraoperatively identifies tumor characteristics of low-risk disease in endometrial carcinoma that predict a very low likelihood of nodal metastasis and recurrence. Although a small number of patients with advanced stage disease may be missed when applying the Mayo criteria, there is no apparent survival benefit to lymphadenectomy for patients satisfying this algorithm, and these data support its use at other institutions.

Duke Scholars

Published In

Gynecol Oncol

DOI

EISSN

1095-6859

Publication Date

October 2011

Volume

123

Issue

1

Start / End Page

65 / 70

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Retrospective Studies
  • Reproducibility of Results
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Monitoring, Intraoperative
  • Middle Aged
  • Lymphatic Metastasis
  • Lymph Nodes
  • Humans
 

Citation

APA
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ICMJE
MLA
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Convery, P. A., Cantrell, L. A., Di Santo, N., Broadwater, G., Modesitt, S. C., Secord, A. A., & Havrilesky, L. J. (2011). Retrospective review of an intraoperative algorithm to predict lymph node metastasis in low-grade endometrial adenocarcinoma. Gynecol Oncol, 123(1), 65–70. https://doi.org/10.1016/j.ygyno.2011.06.025
Convery, Patricia A., Leigh A. Cantrell, Nicola Di Santo, Gloria Broadwater, Susan C. Modesitt, Angeles Alvarez Secord, and Laura J. Havrilesky. “Retrospective review of an intraoperative algorithm to predict lymph node metastasis in low-grade endometrial adenocarcinoma.Gynecol Oncol 123, no. 1 (October 2011): 65–70. https://doi.org/10.1016/j.ygyno.2011.06.025.
Convery PA, Cantrell LA, Di Santo N, Broadwater G, Modesitt SC, Secord AA, et al. Retrospective review of an intraoperative algorithm to predict lymph node metastasis in low-grade endometrial adenocarcinoma. Gynecol Oncol. 2011 Oct;123(1):65–70.
Convery, Patricia A., et al. “Retrospective review of an intraoperative algorithm to predict lymph node metastasis in low-grade endometrial adenocarcinoma.Gynecol Oncol, vol. 123, no. 1, Oct. 2011, pp. 65–70. Pubmed, doi:10.1016/j.ygyno.2011.06.025.
Convery PA, Cantrell LA, Di Santo N, Broadwater G, Modesitt SC, Secord AA, Havrilesky LJ. Retrospective review of an intraoperative algorithm to predict lymph node metastasis in low-grade endometrial adenocarcinoma. Gynecol Oncol. 2011 Oct;123(1):65–70.
Journal cover image

Published In

Gynecol Oncol

DOI

EISSN

1095-6859

Publication Date

October 2011

Volume

123

Issue

1

Start / End Page

65 / 70

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Retrospective Studies
  • Reproducibility of Results
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Monitoring, Intraoperative
  • Middle Aged
  • Lymphatic Metastasis
  • Lymph Nodes
  • Humans