Figure 1
Predictor factors of lymph node metastases in 216 cases of endometrial cancer with known lymph node status
| Variables | No lymph node metastases N = 179 | Lymph node metastases N = 37 | p value |
|---|---|---|---|
| Age (years) | |||
| < 65 | 78 (43.6%) | 12 (32.4%) | 0.211 |
| ≥ 65 | 101 (56.4%) | 25 (67.6%) | |
| Histologic subtype | |||
| Endometrioid | 147 (82.1%) | 23 (62.2%) | 0.007 |
| Non endometrioid | 32 (17.9%) | 14 (37.8%) | |
| Histological Grade | |||
| G1–G2 | 118 (56.9%) | 13 (35.1%) | < 0.001 |
| G3 | 61 (43.1%) | 24 (64.9%) | |
| Myometrial invasion | |||
| < 50% | 90 (50.3%) | 8 (21.6%) | 0.001 |
| ≥ 50% | 89 (49.7%) | 29 (78.4%) | |
| Maximum tumor size | |||
| < 2 cm | 43 (24.0%) | 6 (16.2%) | 0.390 |
| ≥ 2 cm | 136 (76.0%) | 31 (83.8%) | |
| MR tumor volume | |||
| < 10 cm3 | 61 (34.1%) | 5 (13.5%) | 0.013 |
| ≥ 10 cm3 | 118 (65.9%) | 32 (86.5%) |
Baseline patient´s characteristics
| Variable | N=341 |
|---|---|
| Age (years) | 65.7 [58.0–74.0] |
| < 65y | 186 (54.5%) |
| ≥ 65y | 155 (45.5%) |
| BMI (kg/m2) | 29.3 [24.8–33.0] |
| < 30 | 200 (58.7%) |
| ≥ 30 | 141 (41.3%) |
| Histologic subtype | |
| Endometrioid | 278 (81.5%) |
| Mucinous | 5 (1.5) |
| Squamous | 6 (1.8%) |
| Serous Papillary | 23 (6.7%) |
| Clear cells | 13 (3.8%) |
| Mixed mesodermal tumors | 12 (3.5%) |
| Undifferenced | 1 (0.3%) |
| Histological Grade | |
| G1 | 159 (46.6%) |
| G2 | 86 (25.2%) |
| G3 | 96 (28.25%) |
| Myometrial invasion | |
| < 50% | 207 (60.7%) |
| ≥ 50% | 134 (39.3%) |
| FIGO stage | |
| I | 270 (79.2%) |
| II | 15 (4.4%) |
| III | 45 (13.2%) |
| IV | 11 (3.2%) |
| Surgical treatment | |
| HT & BSO alone | |
| With pelvic lymphadenectomy | 96 (37.4%) |
| With pelvic & paraaortic | 74 (28.8%) |
| lymphadenectomy | 87 (33.9%) |
| Lymph nodes status (N = 216) | |
| Negatives | 179 (82.9%) |
| Positives | 37 (17.1%) |
| Adjuvant treatment | |
| None | 150 (44.0%) |
| Irradiation | 146 (42.8%) |
| Chemotherapy | 9 (2.6%) |
| Irradiation and Chemotherapy | 36 (10.6%) |
| Follow-up (months) | 30.5 (18.5–46.2) |
| Recurrence | 51 (15.0%) |
| Decrease | 29 (8.5%) |
Multivariant analysis of disease-free and overall survival using Cox regression model with the classic histological prognostic factors
| Variables | Disease-free survival | p value | Overall survival | p value |
|---|---|---|---|---|
| MRI tumor volume | ||||
| < 10 cm3 | 1 | 1 | ||
| ≥ 10 cm3 | 2.20 (1.09–4.45) | 0.029 | 3.88 (1.34–11.24) | 0.012 |
| Histologic subtype | ||||
| Endometrioid | 1 | 1 | ||
| Non endometrioid | 1.06 (0.50–2.24) | 0.873 | 1.16 (0.43–3.16) | 0.766 |
| Histological Grade | ||||
| G1–G2 | 1 | 1 | ||
| G3 | 3.60 (1.95–6.66) | < 0.001 | 3.07 (1.47–6.41) | 0.003 |
| Myometrial invasion | ||||
| < 50% | 1 | 1 | ||
| ≥ 50% | 1.77 (1.01–4.46) | 0.047 | 1.51 (0.72–3.17) | 0.279 |
Analysis of disease-free and overall survival using Cox regression model
| Variables | Disease-free | p value | overall | p value |
|---|---|---|---|---|
| Age (continue, years) | 1.06 (1.03–1.09) | < 0.001 | 1.09 (1.05–1.13) | < 0.001 |
| MRI tumor volume | ||||
| < 10 cm3 | 1 | 1 | ||
| ≥ 10 cm3 | 2.99 (1.50–5.99) | 0.001 | 4.50 (1.56–12.93) | 0.005 |
| Histologic subtype | ||||
| Endometrioid | 1 | 1 | ||
| Non endometrioid | 2.55 (1.30–5.01) | 0.006 | 2.40 (0.97–5.95) | 0.052 |
| Histological Grade | ||||
| G1–G2 | 1 | 1 | ||
| G3 | 4.02 (2.31–6.98) | < 0.001 | 3.55 (1.71–7.37) | 0.001 |
| Myometrial invasion | ||||
| < 50% | 1 | 1 | ||
| ≥ 50% | 2.10 (1.20–3.64) | 0.009 | 1.89 (0.91–3.93) | 0.088 |
| FIGO stage | ||||
| I–II | 1 | 1 | ||
| III–IV | 6.70 (3.83–11.72) | < 0.001 | 3.94 (1.79–8.68) | 0.001 |
Relation between tumor volume measured by magnetic resonance and pathological factors in 341 endometrial cancer
| Variables | MR tumor volume cm3 | p value * = Mann-Whitney U independent sample test; BMI = body mass index; FIGO = International Federation of Gynecology and Obstetrics |
|---|---|---|
| Tumoral volume | 8.2 (1.9–20.4) | - |
| Age (years) | ||
| < 65 | 5.4 (1.5–15.4) | 0.001 |
| ≥ 65 | 11.0 (2.8–30.0) | |
| BMI (kg/m2) | ||
| < 30 | 9.1 (2.3–22.3) | 0.525 |
| ≥ 30 | 7.5 (1.6–23.6) | |
| Histologic subtype | ||
| Endometrioid | 7.9 (1.8–20.4) | 0.859 |
| Non endometrioid | 12.4 (3.3–40.1) | |
| Histological Grade | ||
| G1–G2 | 6.7 (1.3–17.2) | < 0.001 |
| G3 | 13.8 (4.6–41.0) | |
| Myometrial invasion | ||
| < 50% | 4.6 (1.2–15.4) | < 0.001 |
| ≥ 50% | 14.1 (5.7–35.1) | |
| FIGO stage | ||
| I–II | 7.6 (1.5–19.6) | < 0.001 |
| III–IV | 15.6 (6.5–44.7) | |
| Lymph node status (N = 216) | ||
| Negatives | 9.3 (3.3–20.9) | 0.008 |
| Positives | 15.6 (6.3–40.7) | |
| Recurrence | ||
| No | 7.6 (1.7–17.4) | < 0.001 |
| Yes | 22.4 (5.6–49.2) | |
| Overall Survival | ||
| Alive | 8.0 (1.8–18.6) | < 0.001 |
| Death | 30.5 (9.6–56.4) |