A novel model to estimate lymph node metastasis in endometrial cancer patients
Autor(a) principal: | |
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Data de Publicação: | 2017 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Clinics |
Texto Completo: | https://www.revistas.usp.br/clinics/article/view/127273 |
Resumo: | OBJECTIVES: To evaluate the postoperative pathological characteristics of hysterectomy specimens, preoperative cancer antigen (CA)-125 levels and imaging modalities in patients with endometrial cancer and to build a risk matrix model to identify and recruit patients for retroperitoneal lymphadenectomy. METHODS: A total of 405 patients undergoing surgical treatment for endometrial cancer were retrospectively reviewed and analyzed. Clinical (age and body mass index), laboratory (CA-125), radiological (lymph node evaluation), and pathological (tumour size, grade, lymphovascular space invasion, lymph node metastasis, and myometrial invasion) parameters were used to test the ability to predict lymph node metastasis. Four parameters were selected by logistic regression to create a risk matrix for nodal metastasis. RESULTS: Of the 405 patients, 236 (58.3%) underwent complete pelvic and para-aortic lymphadenectomy, 96 (23.7%) underwent nodal sampling, and 73 (18%) had no surgical lymph node assessment. The parameters predicting nodal involvement obtained through logistic regression were myometrial infiltration >;50%, lymphovascular space involvement, pelvic lymph node involvement by imaging, and a CA-125 value >;21.5 U/mL. According to our risk matrix, the absence of these four parameters implied a risk of lymph node metastasis of 2.7%, whereas in the presence of all four parameters the risk was 82.3%. CONCLUSION: Patients without deep myometrial invasion and lymphovascular space involvement on the final pathological examination and with normal CA-125 values and lymph node radiological examinations have a relatively low risk of lymph node involvement. This risk assessment matrix may be able to refer patients with high-risk parameters necessitating lymphadenectomy and to decide the risks and benefits of lymphadenectomy. |
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oai:revistas.usp.br:article/127273 |
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Clinics |
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A novel model to estimate lymph node metastasis in endometrial cancer patients OBJECTIVES: To evaluate the postoperative pathological characteristics of hysterectomy specimens, preoperative cancer antigen (CA)-125 levels and imaging modalities in patients with endometrial cancer and to build a risk matrix model to identify and recruit patients for retroperitoneal lymphadenectomy. METHODS: A total of 405 patients undergoing surgical treatment for endometrial cancer were retrospectively reviewed and analyzed. Clinical (age and body mass index), laboratory (CA-125), radiological (lymph node evaluation), and pathological (tumour size, grade, lymphovascular space invasion, lymph node metastasis, and myometrial invasion) parameters were used to test the ability to predict lymph node metastasis. Four parameters were selected by logistic regression to create a risk matrix for nodal metastasis. RESULTS: Of the 405 patients, 236 (58.3%) underwent complete pelvic and para-aortic lymphadenectomy, 96 (23.7%) underwent nodal sampling, and 73 (18%) had no surgical lymph node assessment. The parameters predicting nodal involvement obtained through logistic regression were myometrial infiltration >;50%, lymphovascular space involvement, pelvic lymph node involvement by imaging, and a CA-125 value >;21.5 U/mL. According to our risk matrix, the absence of these four parameters implied a risk of lymph node metastasis of 2.7%, whereas in the presence of all four parameters the risk was 82.3%. CONCLUSION: Patients without deep myometrial invasion and lymphovascular space involvement on the final pathological examination and with normal CA-125 values and lymph node radiological examinations have a relatively low risk of lymph node involvement. This risk assessment matrix may be able to refer patients with high-risk parameters necessitating lymphadenectomy and to decide the risks and benefits of lymphadenectomy. Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo2017-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/clinics/article/view/12727310.6061/clinics/2017(01)06Clinics; Vol. 72 No. 1 (2017); 30-35Clinics; v. 72 n. 1 (2017); 30-35Clinics; Vol. 72 Núm. 1 (2017); 30-351980-53221807-5932reponame:Clinicsinstname:Universidade de São Paulo (USP)instacron:USPenghttps://www.revistas.usp.br/clinics/article/view/127273/124471Copyright (c) 2017 Clinicsinfo:eu-repo/semantics/openAccessAnton, Cristinae Silva, Alexandre SilvaBaracat, Edmund ChadaDogan, Nasuh UtkuKöhler, ChristhardtCarvalho, Jesus Pauladi Favero, Giovanni Mastrantonio2017-03-15T15:55:12Zoai:revistas.usp.br:article/127273Revistahttps://www.revistas.usp.br/clinicsPUBhttps://www.revistas.usp.br/clinics/oai||clinics@hc.fm.usp.br1980-53221807-5932opendoar:2017-03-15T15:55:12Clinics - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
A novel model to estimate lymph node metastasis in endometrial cancer patients |
title |
A novel model to estimate lymph node metastasis in endometrial cancer patients |
spellingShingle |
A novel model to estimate lymph node metastasis in endometrial cancer patients Anton, Cristina |
title_short |
A novel model to estimate lymph node metastasis in endometrial cancer patients |
title_full |
A novel model to estimate lymph node metastasis in endometrial cancer patients |
title_fullStr |
A novel model to estimate lymph node metastasis in endometrial cancer patients |
title_full_unstemmed |
A novel model to estimate lymph node metastasis in endometrial cancer patients |
title_sort |
A novel model to estimate lymph node metastasis in endometrial cancer patients |
author |
Anton, Cristina |
author_facet |
Anton, Cristina e Silva, Alexandre Silva Baracat, Edmund Chada Dogan, Nasuh Utku Köhler, Christhardt Carvalho, Jesus Paula di Favero, Giovanni Mastrantonio |
author_role |
author |
author2 |
e Silva, Alexandre Silva Baracat, Edmund Chada Dogan, Nasuh Utku Köhler, Christhardt Carvalho, Jesus Paula di Favero, Giovanni Mastrantonio |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
Anton, Cristina e Silva, Alexandre Silva Baracat, Edmund Chada Dogan, Nasuh Utku Köhler, Christhardt Carvalho, Jesus Paula di Favero, Giovanni Mastrantonio |
description |
OBJECTIVES: To evaluate the postoperative pathological characteristics of hysterectomy specimens, preoperative cancer antigen (CA)-125 levels and imaging modalities in patients with endometrial cancer and to build a risk matrix model to identify and recruit patients for retroperitoneal lymphadenectomy. METHODS: A total of 405 patients undergoing surgical treatment for endometrial cancer were retrospectively reviewed and analyzed. Clinical (age and body mass index), laboratory (CA-125), radiological (lymph node evaluation), and pathological (tumour size, grade, lymphovascular space invasion, lymph node metastasis, and myometrial invasion) parameters were used to test the ability to predict lymph node metastasis. Four parameters were selected by logistic regression to create a risk matrix for nodal metastasis. RESULTS: Of the 405 patients, 236 (58.3%) underwent complete pelvic and para-aortic lymphadenectomy, 96 (23.7%) underwent nodal sampling, and 73 (18%) had no surgical lymph node assessment. The parameters predicting nodal involvement obtained through logistic regression were myometrial infiltration >;50%, lymphovascular space involvement, pelvic lymph node involvement by imaging, and a CA-125 value >;21.5 U/mL. According to our risk matrix, the absence of these four parameters implied a risk of lymph node metastasis of 2.7%, whereas in the presence of all four parameters the risk was 82.3%. CONCLUSION: Patients without deep myometrial invasion and lymphovascular space involvement on the final pathological examination and with normal CA-125 values and lymph node radiological examinations have a relatively low risk of lymph node involvement. This risk assessment matrix may be able to refer patients with high-risk parameters necessitating lymphadenectomy and to decide the risks and benefits of lymphadenectomy. |
publishDate |
2017 |
dc.date.none.fl_str_mv |
2017-01-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/127273 10.6061/clinics/2017(01)06 |
url |
https://www.revistas.usp.br/clinics/article/view/127273 |
identifier_str_mv |
10.6061/clinics/2017(01)06 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/127273/124471 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2017 Clinics info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2017 Clinics |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
dc.source.none.fl_str_mv |
Clinics; Vol. 72 No. 1 (2017); 30-35 Clinics; v. 72 n. 1 (2017); 30-35 Clinics; Vol. 72 Núm. 1 (2017); 30-35 1980-5322 1807-5932 reponame:Clinics instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Clinics |
collection |
Clinics |
repository.name.fl_str_mv |
Clinics - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
||clinics@hc.fm.usp.br |
_version_ |
1800222763102765056 |