Open AccessThe significance of clinical and hormonal-metabolic parameters in the preoperative prediction of the risk of lymphogenous metastasis in patients with stage I endometrial cancer
Author(s) -
А. Ю. Кишкина,
Н. В. Юнусова,
Л. А. Коломиец,
Е. С. Колегова,
И. В. Кондакова
Publication year - 2021
Publication title -
voprosy onkologii
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.108
H-Index - 11
eISSN - 2949-4915
pISSN - 0507-3758
DOI - 10.37469/0507-3758-2021-67-1-105-110
Subject(s) - medicine , endometrial cancer , body mass index , stage (stratigraphy) , metastasis , lymphadenectomy , oncology , cancer , hysterectomy , gastroenterology , radiology , biology , paleontology
In patients with moderately differentiated endometrial cancer with less than half myometrial invasion, there are no specific indications for performing or not performing lymphadenectomy. Given the high prevalence of metabolic syndrome (MS) among patients with endometrial cancer (up to 62%) and a large proportion of G2 tumors in combination with MS, the anthropometric and hormonal-metabolic parameters were considered for predicting the risk of lymphogenous metastasis. To build a model of preoperative prognosis of lymphogenous metastasis, the method of logistic regression was used. Data on 53 patients with stage I endometrial cancer was analyzed. All patients underwent total laparoscopic hysterectomy with bilateral salpingo-ovariectomy and pelvic lymphadenectomy. Positive lymph nodes were found in the surgical specimen of six patients. The additional risk parameters for lymphogenous metastasis were revealed in patients with stage I endometrial cancer, namely: leptin level (AUC = 0.957), visfatin level (AUC = 0.918), body mass index (AUC = 0.911), patient age (AUC = 0.828), and HDL cholesterol (AUC = 0.699). In addition to traditional risk factors (the depth of invasion and tumor differentiation grade), the model of preoperative prediction of the risk of lymphogenous metastasis for patients with intermediate- risk stage I endometrial cancer included the following parameters: age, body mass index, HDL cholesterol, level of adipose hormones leptin and visfatin in blood plasma.. The sensitivity and specificity of the model were 83.3% and 97.9%, respectively.