Akademik Veri Yönetim Sistemi
INDIAN JOURNAL OF GYNECOLOGIC ONCOLOGY, cilt.21, sa.1, 2023 (ESCI)
Purpose In this study, we aimed to assess the efficacy of different tumor diameter cutoffs in diagnosing lymphatic metastasis in low-grade endometrioid endometrial cancer patients with superficial myometrial invasion. Methods Clinical early-stage endometrioid endometrial cancer patients with myometrial invasion < 50% who underwent comprehensive staging, including at least pelvic lymphadenectomy, were retrospectively analyzed. Diagnostic accuracy for detecting lymphatic metastasis and unnecessary lymphadenectomy procedure rates were calculated separately for tumor diameter > 20 mm and tumor diameter > 30 mm. Results Two hundred and three patients fulfilled the study criteria exactly. Seven (3.44%) patients were diagnosed with lymphatic metastasis. If tumor diameter >= 20 mm was taken as a cutoff for the systematic lymphadenectomy, 128 (63%) patients had this procedure, and we would diagnose all lymphatic metastases. If the tumor diameter cutoff value were determined as 30 mm, the systematic lymphadenectomy rate would be 31.5% (n = 64). However, three of the seven lymphatic metastases would be missed. Sensitivity, specificity, positive predictive value, negative predictive value, and false-negative rates were 100%, 38.27%, 5.47%, 100%, and 0%, respectively, for the Mayo Algorithm (20 mm cutoff value) and 57.14%, 69.39%, 6.25% and 97.84% and 42.86%, respectively, for the 30 mm cutoff value for the diagnosis of lymphatic metastasis. Conclusion Two-thirds of the low-grade, superficial myoinvasive endometrial cancer patients were included in a high-risk group for lymphatic metastasis after using 20 mm tumor diameter as a cutoff value. Many cases still undergo unnecessary systematic lymphadenectomy. On the other hand, increasing tumor diameter cutoff from 20 to 30 mm will decrease the lymphadenectomy rate by 50%, but a high false-negative rate makes this approach useless.