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 nonendometrioid 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 nonendometrioid 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.