A Model to Identify Candidates for Lymph Node Dissection Among Patients With High-Risk Endometrial Endometrioid Carcinoma According to Mayo Criteria
BackgroundThe Mayo criteria are the most widely accepted algorithm for predicting the risk of lymph node metastasis in endometrial endometrioid carcinoma (EEC). However, the clinical value of these criteria in high-risk patients is limited and inconclusive.MethodsA total of 240 patients with EEC mee...
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| Format: | Article |
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Frontiers Media S.A.
2022-06-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.895834/full |
| _version_ | 1811242809632489472 |
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| author | Wen Lu Xiaoyue Chen Jingyi Ni Zhen Li Tao Su Shuangdi Li Xiaoping Wan |
| author_facet | Wen Lu Xiaoyue Chen Jingyi Ni Zhen Li Tao Su Shuangdi Li Xiaoping Wan |
| author_sort | Wen Lu |
| collection | DOAJ |
| description | BackgroundThe Mayo criteria are the most widely accepted algorithm for predicting the risk of lymph node metastasis in endometrial endometrioid carcinoma (EEC). However, the clinical value of these criteria in high-risk patients is limited and inconclusive.MethodsA total of 240 patients with EEC meeting the Mayo high-risk criteria between January 1, 2015, and December 31, 2018 were included in our study. We retrospectively collected the laboratory reports, basic clinical information, clinicopathological and immunohistochemistry (IHC) findings, and the sequences of molecular pathological markers of these patients. A nomogram for predicting the likelihood of positive lymph node status was established based on these parameters.ResultsAmong the 240 patients, 17 were diagnosed with lymph node metastasis. The univariable analyses identified myometrial invasion >50%, aberrant p53 expression, microsatellite instable (MSI), and cancer antigen 125 (CA125) ≥35 U/ml as potential risk factors for lymph node metastasis. The multivariable analyses showed that aberrant p53 expression, MSI, and CA125 ≥35 U/ml were independent predictors of lymph node metastasis. The area under the curve (AUC) for the nomogram was 0.870, as compared to 0.665 for the Mayo criteria.ConclusionsOur novel prediction model effectively identifies patients at high risk for lymphatic metastasis. This model is a promising strategy for personalized surgery in patients with high risk according to the Mayo criteria. |
| first_indexed | 2024-04-12T13:57:28Z |
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| id | doaj.art-18d610a11b96415f869c6ff3a0c8a92f |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-12T13:57:28Z |
| publishDate | 2022-06-01 |
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| series | Frontiers in Oncology |
| spelling | doaj.art-18d610a11b96415f869c6ff3a0c8a92f2022-12-22T03:30:19ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-06-011210.3389/fonc.2022.895834895834A Model to Identify Candidates for Lymph Node Dissection Among Patients With High-Risk Endometrial Endometrioid Carcinoma According to Mayo CriteriaWen Lu0Xiaoyue Chen1Jingyi Ni2Zhen Li3Tao Su4Shuangdi Li5Xiaoping Wan6Department of Gynecology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tong Ji University, Shanghai, ChinaDepartment of Gynecology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tong Ji University, Shanghai, ChinaDepartment of Clinical Research Center, Shanghai First Maternity and Infant Hospital, School of Medicine, Tong Ji University, Shanghai, ChinaDepartment of Clinical Research Center, Shanghai First Maternity and Infant Hospital, School of Medicine, Tong Ji University, Shanghai, ChinaDepartment of Gynecology, The International Peace Maternity & Child Health Hospital of China Welfare Institute, Shanghai Jiaotong University, Shanghai, ChinaDepartment of Gynecology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tong Ji University, Shanghai, ChinaDepartment of Gynecology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tong Ji University, Shanghai, ChinaBackgroundThe Mayo criteria are the most widely accepted algorithm for predicting the risk of lymph node metastasis in endometrial endometrioid carcinoma (EEC). However, the clinical value of these criteria in high-risk patients is limited and inconclusive.MethodsA total of 240 patients with EEC meeting the Mayo high-risk criteria between January 1, 2015, and December 31, 2018 were included in our study. We retrospectively collected the laboratory reports, basic clinical information, clinicopathological and immunohistochemistry (IHC) findings, and the sequences of molecular pathological markers of these patients. A nomogram for predicting the likelihood of positive lymph node status was established based on these parameters.ResultsAmong the 240 patients, 17 were diagnosed with lymph node metastasis. The univariable analyses identified myometrial invasion >50%, aberrant p53 expression, microsatellite instable (MSI), and cancer antigen 125 (CA125) ≥35 U/ml as potential risk factors for lymph node metastasis. The multivariable analyses showed that aberrant p53 expression, MSI, and CA125 ≥35 U/ml were independent predictors of lymph node metastasis. The area under the curve (AUC) for the nomogram was 0.870, as compared to 0.665 for the Mayo criteria.ConclusionsOur novel prediction model effectively identifies patients at high risk for lymphatic metastasis. This model is a promising strategy for personalized surgery in patients with high risk according to the Mayo criteria.https://www.frontiersin.org/articles/10.3389/fonc.2022.895834/fullendometrialendometrioid carcinomalymph node dissectionMayo criterionmolecular pathological markersserum CA125 |
| spellingShingle | Wen Lu Xiaoyue Chen Jingyi Ni Zhen Li Tao Su Shuangdi Li Xiaoping Wan A Model to Identify Candidates for Lymph Node Dissection Among Patients With High-Risk Endometrial Endometrioid Carcinoma According to Mayo Criteria Frontiers in Oncology endometrial endometrioid carcinoma lymph node dissection Mayo criterion molecular pathological markers serum CA125 |
| title | A Model to Identify Candidates for Lymph Node Dissection Among Patients With High-Risk Endometrial Endometrioid Carcinoma According to Mayo Criteria |
| title_full | A Model to Identify Candidates for Lymph Node Dissection Among Patients With High-Risk Endometrial Endometrioid Carcinoma According to Mayo Criteria |
| title_fullStr | A Model to Identify Candidates for Lymph Node Dissection Among Patients With High-Risk Endometrial Endometrioid Carcinoma According to Mayo Criteria |
| title_full_unstemmed | A Model to Identify Candidates for Lymph Node Dissection Among Patients With High-Risk Endometrial Endometrioid Carcinoma According to Mayo Criteria |
| title_short | A Model to Identify Candidates for Lymph Node Dissection Among Patients With High-Risk Endometrial Endometrioid Carcinoma According to Mayo Criteria |
| title_sort | model to identify candidates for lymph node dissection among patients with high risk endometrial endometrioid carcinoma according to mayo criteria |
| topic | endometrial endometrioid carcinoma lymph node dissection Mayo criterion molecular pathological markers serum CA125 |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.895834/full |
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