Dr. Fon-Jou Hsieh and colleagues, of National Taiwan University Hospital in Taipei, studied 42 patients with endometrial cancer who were imaged with two-dimensional color Doppler ultrasound one day before they underwent hysterectomy and dissection or sampling of pelvic and para-aortic lymph nodes.
All patients included in the study had "...histologic grade 2/3 or endocervical involvement" or "...tumors with grossly myometrial invasion," according to the research team's paper in the December issue of Gynecologic Oncology.
Surgical results showed that 12 patients had lymph node metastases, the investigators report. The incidence of nodal metastasis was significantly correlated with tumors larger than 2.5 cm, myometrial invasion more than half the distance from the serosa to the endometrium, and an intratumoral arterial resistance index of less than 0.4.
On multivariate analysis, only the intratumoral resistance index was significantly correlated with metastasis, the researchers determined.
"Lymphadenectomy for pathologic proof is the definite diagnosis for lymph node metastases," Dr. Hsieh's group writes. "However, lymphadenectomy has been associated with increased mean operative time, higher blood loss, and longer postoperative hospital stay....It seems that gray-scale and color Doppler ultrasound could be used as a tool for predicting lymph node metastases."
Gynecol Oncol 1998;71:424-427.
-Westport Newsroom 203 319 2700