Endometrial cancer is the most common malignancy of the female reproductive tract. Lymph node metastases are an important prognostic factor in endometrial cancer. Several prognostic factors have been shown to correlate with lymph node metastasis, including depth of myometrial invasion, cervical infiltration, histologic grade of the tumor, tumor diameter, histology type, lymphovascular invasion, and positive peritoneal cytology. The aim of the study was to identify the histopathologic parameters that would indicate with greater certainty the possibility of metastases into lymph nodes, which would serve as a basis to assess whether patients should undergo lymphadenectomy or not. This retrospective study included patients with endometrial cancer having undergone surgery at the Oncology Institute of Vojvodina during the 2012-2018 period. The study included 120 patients having undergone hysterectomy with bilateral adnexectomy and pelvic lymphadenectomy. Among patients who had lymph node metastases, there were statistically significantly more patients (p<0.01) with endometrial cancer histologic type 2, depth of myometrial invasion greater than 50%, cervical stroma infiltration, lymphovascular invasion, and positive peritoneal cytology. In conclusion, histopathologic parameters such as type 2 endometrial cancer, myometrial invasion depth greater than 50%, cervical stroma infiltration, lymphovascular invasion and positive peritoneal cytology increased the likelihood of lymph node metastases. Tumor size (>2 cm), as well as histologic grade did not correlate with a higher incidence of lymph node metastases. In this study, both parametrial infiltration and the number of lymph nodes removed were found to have clinical relevance but not statistical significance.
Keywords: Endometrial cancer; Lymph node metastases; Lymphadenectomy.