Establishment and evaluation of a risk‐scoring system for lymph node metastasis in early‐stage endometrial carcinoma: Achieving preoperative risk stratification
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.