Establishment and evaluation of a risk‐scoring system for lymph node metastasis in early‐stage endometrial carcinoma: Achieving preoperative risk stratification. Issue 11 (25th August 2020)

• Record Type: Journal Article
• Authors: Zhang, Ying; Zhao, Weidong; Chen, Zhengzheng; Zhao, Xuxu; Ren, Pingping; Zhu, Meiling
• Is Part Of: Journal of obstetrics and gynaecology research. Volume 46:Issue 11(2020)
• Page Start: 2305
• Page End: 2313
• Publication Date: 2020-08-25
• Subjects: endometrial carcinoma -- lymph node metastasis -- risk stratification -- scoring system; Gynecology -- Periodicals; Obstetrics -- Periodicals; 618.1005
• DOI: 10.1111/jog.14422
• Languages: English
• ISSNs: 1341-8076

Abstract

Abstract: Aim: To establish a risk‐scoring system for lymph node metastasis (LNM) of early‐stage endometrial carcinoma (EC), and to stratify the preoperative risk of LNM. Methods: We retrospectively analyzed the clinical data of 507 patients diagnosed with the early‐stage EC (i.e., confined to the uterine corpus). We determined the risk factors for LNM by logistic regression analysis; then constructed a simple logistic scoring system, and an additive scoring system based on the regression coefficient ( β ), and odds ratio, of each variable, respectively. Results: The overall rate of LNM was 9.1% (46/507). Multivariate analysis showed that preoperative serum cancer antigen 125 (CA125) ≥35 U/mL, histopathology of grade 3 and/or type II, depth of myometrial invasion ≥1/2 and positive immunostaining for Ki‐67 ≥50%, were independent risk factors for LNM ( P < 0.05). The simple logistic and additive scoring systems exhibited good predictive ability (area under the curve [AUC] >0.8). Based on the additive scoring system, the risk of LNM in patients with early‐stage EC was classified into three groups: a low‐risk group (total score: <5), an intermediate‐risk group (total score: 5– 10) and a high‐risk group (total score: >10). The incidence of LNM differed significantly across these three groups ( P < 0.05). Conclusion: The risk‐scoring system constructed in this study can effectively predict the risk of LNM in patients with early‐stage EC, achieve preoperative risk stratification and provide a reference guideline for the use of lymphadenectomy.