Pelvic lymph node metastasis in endometrial cancer with no myometrial invasion

Objective: To analyze the incidence of pelvic lymph node metastasis in endometrial carcinoma with no myometrial invasion. Methods: Between 1971 and 1995, 684 women with stage I endometrial carcinoma underwent total abdominal hysterec tomy, bilateral salpingo-oophorectomy, and pelvic lymphadenectomy. The incidence of pelvic lymph node metastases in 100 cases without myometrial invasion was examined. Results: Histologic examination of the surgical specimens revealed a single pelvic lymph node metastasis in each of four cases. The incidence of pelvic lymph node metastasis was four of 83 in grade 1, zero of 13 in grade 2, and zero of four in grade 3 tumors. Conclusion: Pelvic lymph node metastasis in endometrial cancer with no myometrial invasion is not rare, even with grade 1 tumors. Lymphadenectomies may be necessary in all patients with endometrial cancer, except when clinical or operative factors increase the procedure's risk of morbidity.