Magnetic Resonance Imaging And Preoperative Histology For The Evaluation Of Risk Factors Associated With Lymph Node Metastasis In Endometrial Cancer

Objective:To analyze the accuracy of magnetic resonance imaging(MRI)and preoperative histology for predicting the low-and high-risk patients associated with lymph node(LN)metastasis in patients with surgically staged endometrial cancer.Methods:The medical records of 134 patients with endometrial cancer who underwent surgical treatment between November 2013 and November 2016 were retrospectively analyzed.Results of preoperative evaluation of Myometrial invasion and Lymph node metastasis by MRI,histological type and grade by preoperative histology were compared to final histological examination.Results:Our results showed a high specificity and negative predictive value of MRI for the evaluation of myometrial invasion,cervical stromal invasion and LN metastasis.The combination of preoperative histology and MRI recognized high-risk carcinomas with a good discriminatory power(AUC 0.814).Further,the method showed moderate agreement with postoperative findings(kappa 0.623).Of the 39 patients identified as low risk by both MRI and preoperative histology,none had pelvic or para-aortic LN metastases in the final pathology.Conclusions:The results indicate that MRI and preoperative histology may be useful for the evaluation of risk factors associated with LN metastasis in patients with endometrial cancer.Magnetic resonance imaging and preoperative histology can be used to accurately identify low-risk patients who do not need comprehensive surgical staging and may prevent unnecessary lymphadenectomy.