Validation of an Endometrial Tumor Diameter Model for Risk Assessment in the Absence of Lymph Node Mapping
Purpose: This study aimed to assess the optimal tumor diameter for predicting lymphatic metastasis and to determine intraoperatively the need for lymph node dissection in patients with endometrioid endometrial cancer. Methods: Military beneficiaries diagnosed with stage I–III endometrioid endomet...
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| Format: | Article |
| Language: | English |
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Advocate Aurora Health
2020-10-01
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| Series: | Journal of Patient-Centered Research and Reviews |
| Subjects: | |
| Online Access: | https://institutionalrepository.aah.org/cgi/viewcontent.cgi?article=1768&context=jpcrr |
| _version_ | 1797934645792210944 |
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| author | McKayla J. Riggs Callie M. Cox Bauer Caela R. Miller James K. Aden Scott A. Kamelle |
| author_facet | McKayla J. Riggs Callie M. Cox Bauer Caela R. Miller James K. Aden Scott A. Kamelle |
| author_sort | McKayla J. Riggs |
| collection | DOAJ |
| description | Purpose: This study aimed to assess the optimal tumor diameter for predicting lymphatic metastasis and to determine intraoperatively the need for lymph node dissection in patients with endometrioid endometrial cancer.
Methods: Military beneficiaries diagnosed with stage I–III endometrioid endometrial cancer during 2003–2016 who had at least 7 pelvic and/or paraaortic lymph nodes removed during the time of hysterectomy were studied. Tumor diameter was compared against the presence of positive nodes, using the prior models of 20 mm (ie, Mayo model) and 50 mm (ie, Milwaukee model), to determine the false-negative rate of each threshold. A separate analysis was completed to determine the optimal diameter for our population. Receiver operating characteristic curve analysis models of tumor diameter were evaluated for model fit and predictive power of lymph node involvement.
Results: Of the 1224 patients with endometrioid endometrial cancer included, 13% (n = 160) had positive lymph node involvement. Tumor sizes ranged from 1 mm to 100 mm. In contrast to Mayo and Milwaukee models (ie, Mayo, Milwaukee), the optimal tumor diameter independent of myometrial invasion and grade of tumor to predict lymph node metastasis was found to be 35 mm.
Conclusions: Endometrioid endometrial cancer tumor diameter of 35 mm was found to be the optimal threshold for lymphadenectomy when the operating surgeon has no knowledge of tumor invasion. |
| first_indexed | 2024-04-10T18:02:11Z |
| format | Article |
| id | doaj.art-eccab4f18719422dae3f4c59d5d5a000 |
| institution | Directory Open Access Journal |
| issn | 2330-0698 |
| language | English |
| last_indexed | 2024-04-10T18:02:11Z |
| publishDate | 2020-10-01 |
| publisher | Advocate Aurora Health |
| record_format | Article |
| series | Journal of Patient-Centered Research and Reviews |
| spelling | doaj.art-eccab4f18719422dae3f4c59d5d5a0002023-02-02T15:05:16ZengAdvocate Aurora HealthJournal of Patient-Centered Research and Reviews2330-06982020-10-017432332810.17294/2330-0698.1768Validation of an Endometrial Tumor Diameter Model for Risk Assessment in the Absence of Lymph Node MappingMcKayla J. Riggs0Callie M. Cox Bauer1Caela R. Miller2James K. Aden3Scott A. Kamelle4Brooke Army Medical Center, San Antonio, TXBrooke Army Medical Center, San Antonio, TX; Aurora Sinai Medical Center, Milwaukee, WIBrooke Army Medical Center, San Antonio, TXBrooke Army Medical Center, San Antonio, TXAurora St. Luke's Medical Center, Milwaukee, WIPurpose: This study aimed to assess the optimal tumor diameter for predicting lymphatic metastasis and to determine intraoperatively the need for lymph node dissection in patients with endometrioid endometrial cancer. Methods: Military beneficiaries diagnosed with stage I–III endometrioid endometrial cancer during 2003–2016 who had at least 7 pelvic and/or paraaortic lymph nodes removed during the time of hysterectomy were studied. Tumor diameter was compared against the presence of positive nodes, using the prior models of 20 mm (ie, Mayo model) and 50 mm (ie, Milwaukee model), to determine the false-negative rate of each threshold. A separate analysis was completed to determine the optimal diameter for our population. Receiver operating characteristic curve analysis models of tumor diameter were evaluated for model fit and predictive power of lymph node involvement. Results: Of the 1224 patients with endometrioid endometrial cancer included, 13% (n = 160) had positive lymph node involvement. Tumor sizes ranged from 1 mm to 100 mm. In contrast to Mayo and Milwaukee models (ie, Mayo, Milwaukee), the optimal tumor diameter independent of myometrial invasion and grade of tumor to predict lymph node metastasis was found to be 35 mm. Conclusions: Endometrioid endometrial cancer tumor diameter of 35 mm was found to be the optimal threshold for lymphadenectomy when the operating surgeon has no knowledge of tumor invasion.https://institutionalrepository.aah.org/cgi/viewcontent.cgi?article=1768&context=jpcrrendometrioid endometrial cancerlymph node involvementtumor diameterlymphadenectomy |
| spellingShingle | McKayla J. Riggs Callie M. Cox Bauer Caela R. Miller James K. Aden Scott A. Kamelle Validation of an Endometrial Tumor Diameter Model for Risk Assessment in the Absence of Lymph Node Mapping Journal of Patient-Centered Research and Reviews endometrioid endometrial cancer lymph node involvement tumor diameter lymphadenectomy |
| title | Validation of an Endometrial Tumor Diameter Model for Risk Assessment in the Absence of Lymph Node Mapping |
| title_full | Validation of an Endometrial Tumor Diameter Model for Risk Assessment in the Absence of Lymph Node Mapping |
| title_fullStr | Validation of an Endometrial Tumor Diameter Model for Risk Assessment in the Absence of Lymph Node Mapping |
| title_full_unstemmed | Validation of an Endometrial Tumor Diameter Model for Risk Assessment in the Absence of Lymph Node Mapping |
| title_short | Validation of an Endometrial Tumor Diameter Model for Risk Assessment in the Absence of Lymph Node Mapping |
| title_sort | validation of an endometrial tumor diameter model for risk assessment in the absence of lymph node mapping |
| topic | endometrioid endometrial cancer lymph node involvement tumor diameter lymphadenectomy |
| url | https://institutionalrepository.aah.org/cgi/viewcontent.cgi?article=1768&context=jpcrr |
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