Risk factors predictive of para-aortic lymph node metastasis in endometrial carcinomas.

Abstract

To identify risk factors predictive of para-aortic lymph node (PAN) metastasis in endometrial carcinomas. Sixty patients with endometrial carcinomas Stage I to III (FIGO, 1988) who each underwent a complete pelvic and para-aortic lymphadenectomy with a semiradical or radical hysterectomy, bilateral salpingo-oophorectomy, between April 1988 and March 1996, were included in this study. The relationship between PAN metastasis and clinico-pathological factors such as histological type, grade, depth of myometrial invasion (MI), vascular space involvement (VSI), cervical invasion (CI), peritoneal cytology, tumor size, pelvic lymph node (PLN) metastasis, and glutathione S-transferase pi (GST-pi) expression was examined using univariate and multivariate analysis. Seven variables--G3 grade, more than one-half MI, positive VSI, positive CI, tumor size of more than 2 cm in diameter, positive PLN metastasis, and positive GST-pi--were significantly correlated with PAN metastasis using univariate analysis. Multivariate analysis revealed that of the above 7 variables, 3 were significantly and independently correlated with PAN metastasis: more than one-half MI, positive PLN, and positive GST-pi. The relative risk of a patient with these 3 factors having PAN metastasis was 18.0 times greater than the risk for a patient without them. These variables--More than one-half MI, positive PLN, and positive GST-pi--were significantly related to PAN metastasis.