LYMPH-NODE METASTASIS AND PROGNOSIS OF ENDOMETRIAL CARCINOMA

Recently there has been much discussion about the choice of surgical treatment for carcinoma of the body of the uterus. From the study of the literature, it is concluded that there is a high incidence of lymphatic metastases in cases with cervical involvement, so Wertheim's hysterectomy with pelvic lymphadenectomy has been carried out for such cases. Deep myometrial infiltration and involvement of lymphatic vessels within myometrium are also very important factors for pelvic lymph node involvement, but it is quite impossible to examine these two factors preoperatively. As to the sites of spread, paraaortic lymph node involvement seems not so important as was said in the literature. In the case with cervical involvement, the external iliac lymph node is the most often affected, just as in the case of cervical carcinoma. Without cervical involvement, the obturator lymph node and hypogastric lymph node seem to be a primary site for lymphatic spread. The prognosis is poor in patients with involvement of the pelvic lymph node. Radical hysterectomy should be carried out as the general condition permits. © 1979.