The Results of Surgico-Pathologic Factors in Patients with Non-Endometrioid Type Endometrial Cancer: Is Tumor Type Important for Lymph Node Metastasis?

  • Cigdem Kilic Etlik Zubeyde Hanim Women’s Health Teaching and Researching Hospital, Gynecology Clinic
  • Osman Turkmen Etlik Zubeyde Hanim Women’s Health Teaching and Researching Hospital, Gynecologic Oncology Clinic
  • Gunsu Kimyon Comert Etlik Zubeyde Hanim Women’s Health Teaching and Researching Hospital, Gynecologic Oncology Clinic
  • Selcan Sinaci Etlik Zubeyde Hanim Women’s Health Teaching and Researching Hospital, Gynecology Clinic
  • Bulent Yirci Etlik Zubeyde Hanim Women’s Health Teaching and Researching Hospital, Gynecology Clinic
  • Yasin Durmus Etlik Zubeyde Hanim Women’s Health Teaching and Researching Hospital, Gynecologic Oncology Clinic
  • Alper Karalok Etlik Zubeyde Hanim Women’s Health Teaching and Researching Hospital, Gynecologic Oncology Clinic
  • Derman Basaran Etlik Zubeyde Hanim Women’s Health Teaching and Researching Hospital, Gynecologic Oncology Clinic
  • Taner Turan Etlik Zubeyde Hanim Women’s Health Teaching and Researching Hospital, Gynecologic Oncology Clinic
Keywords: Endometrial Cancer, Serous type, Mucinous type, Undifferentiated type, Clear Cell type, Lymph node metastasis

Abstract

Aim: To determine the factors identifying lymph node metastasis and the association between tumor types and surgico-pathologic factors in patients with non-endometrioid type endometrial cancer. Materials and Methods: This study included 150 patients with non-endometrioid type endometrial cancer whose staging surgeries had already been performed in our clinic. Results: Tumor types were serous in 65 patients, clear cell in 55, undifferentiated in 23 and mucinous in 8. Sixty-one patients had stage I, 6 patients had stage II, 47 patients had stage III and 36 of them had stage IV disease. Median removed lymph node number was 52 (range; 2-118). Number of the removed lymph node did not change according to tumor type. Lymph node metastasis and non-nodal extra-uterine disease were detected in 47% and 36% of patients, respectively. The type of tumor predicted the lymphatic spread, deep myometrial invasion, serosal involvement, adnexal spread, cervical invasion and omental metastasis (p<0.05). The lymphatic spread rate was 65% for undifferentiated tumor type and 12.5% for mucinous tumor type. The rate of non-nodal extra-uterine disease was 60.9%, 43.8%, 21.8% and none in patients with undifferentiated, serous, clear cell tumor and mucinous type tumor, respectively (p=0.001). In multivariate analysis, it was determined that tumor type (undifferentiated vs. others), cervical invasion and omental metastasis were independent prognostic factors for lymph node metastasis. Conclusion: Whereas the surgical-pathologic factors were significantly worse in the undifferentiated type than other tumor types, the opposite was true in the mucinous type. Mucinous type tumor is different from other non-endometrioid types in terms of nodal/non-nodal spread. Lymphatic spread was observed in slightly more than 10% of patients with mucinous tumor and non-nodal extra-uterine disease did not exist in those.

Author Biographies

Cigdem Kilic, Etlik Zubeyde Hanim Women’s Health Teaching and Researching Hospital, Gynecology Clinic
gynecologic oncology
Osman Turkmen, Etlik Zubeyde Hanim Women’s Health Teaching and Researching Hospital, Gynecologic Oncology Clinic
gynecologic oncology
Gunsu Kimyon Comert, Etlik Zubeyde Hanim Women’s Health Teaching and Researching Hospital, Gynecologic Oncology Clinic
gynecologic oncology
Selcan Sinaci, Etlik Zubeyde Hanim Women’s Health Teaching and Researching Hospital, Gynecology Clinic
gynecology
Bulent Yirci, Etlik Zubeyde Hanim Women’s Health Teaching and Researching Hospital, Gynecology Clinic
gynecology
Yasin Durmus, Etlik Zubeyde Hanim Women’s Health Teaching and Researching Hospital, Gynecologic Oncology Clinic
gynecologic oncology
Alper Karalok, Etlik Zubeyde Hanim Women’s Health Teaching and Researching Hospital, Gynecologic Oncology Clinic
gynecologic oncology
Derman Basaran, Etlik Zubeyde Hanim Women’s Health Teaching and Researching Hospital, Gynecologic Oncology Clinic
gynecologic oncology
Taner Turan, Etlik Zubeyde Hanim Women’s Health Teaching and Researching Hospital, Gynecologic Oncology Clinic
Gynecologic Oncology

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Published
2019-03-25
Section
Original Research