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Preoperative Assessment of Lymph Node Metastasis in Endometrial Cancer: A Korean Gynecologic Oncology Group Study

Title
Preoperative Assessment of Lymph Node Metastasis in Endometrial Cancer: A Korean Gynecologic Oncology Group Study
Authors
Kang, SokbomNam, Joo-HyunBae, Duk-SooKim, Jae-WeonKim, Moon-HongChen, XiaojunNo, Jae-HongLee, Jong-MinKim, Jae-HoonWatari, HidemichKim, Seok MoKim, Sung HoonSeong, Seok JuKim, Ki TaeKim, Seung CheolKim, Jong-HyeokLim, Myung-CheolLee, Jung-YunRyu, Sang-YoungYang, BingyiKim, Byoung-Gie
Ewha Authors
김승철
SCOPUS Author ID
김승철scopus
Issue Date
2017
Journal Title
CANCER
ISSN
0008-543XJCR Link1097-0142JCR Link
Citation
vol. 123, no. 2, pp. 263 - 272
Keywords
cancer antigen 125 (CA 125)endometrial cancerlymphadenectomylymph nodemagnetic resonance imagingmetastasispredictionrisk factorsurgical staging
Publisher
WILEY-BLACKWELL
Indexed
SCI; SCIE; SCOPUS WOS scopus
Abstract
BACKGROUND: Previously proposed criteria for preoperatively identifying endometrial cancer patients at lowrisk for lymph nodemetastasis remain to be verified. For this purpose, a prospective, multicenter observational studywas performed. METHODS: Eligible patients with histologically confirmed endometrial cancer underwent magnetic resonance imaging (MRI) and serum cancer antigen 125 (CA 125) testing before surgery. The following criteria were used to identify low-risk patients: 1) endometrioid-type cancer, 2) no evidence of deep myometrial invasion on MRI, 3) no enlarged lymph nodes on MRI, 4) no suspicious metastasis out of the uterine corpus, and 5) serum CA 125 levels less than 35 U/mL. Systematic pelvic and/or para-aortic lymphadenectomy was performed for all patients. The primary endpoint was estimation of the negative predictive value (NPV). RESULTS: From January 2012 to December 2014, 529 patients from20 hospitals in 3 Asian countries were consecutively enrolled. According to our criteria, 272 patients (51.4%) were categorized into the low-risk group. Fifty-three of the 529 patients (10.0%) had lymph node metastases; these patients included 8 (2.9%) falsely categorized as low-risk. The sensitivity and specificity of the criteriawere 84.9% and 55.5%, respectively. The NPVof 97.1% was higher than the predefined target endpoint of 96%. CONCLUSIONS: The low-risk criteria based on preoperative tests were confirmed to be reliable and accurate for identifying patients at low risk for lymph node metastasis. These criteria may facilitate patient counseling and surgical decision making. (C) 2016 American Cancer Society.
DOI
10.1002/cncr.30349
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의학전문대학원 > 의학과 > Journal papers
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