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Mayo Criteria Prospective

Prospective Assessment of Lymphatic Dissemination in Endometrial Cancer: A Paradigm Shift in Surgical Staging

Date of Publication:

March 4, 2008

Pubmed Link:
https://pubmed.ncbi.nlm.nih.gov/18304622/
Hypothesis:

Using the Mayo algorithm, for patients who require LND, is a systematic lymphadenectomy required?

Control Arm(s):

LND not required based on Mayo Criteria (grade 1/2 endometrioid type with ≤50% myometrial invasion and ≤2cm tumor)

Experimental Arm(s):

LND required based on Mayo Criteria

Primary End Point:

Lymphatic dissemination in endometrial cancer

Inclusion Criteria:

2004-2006

Endometrial cancer patients treated with surgery at Mayo Clinic

Exclusion Criteria:

Advanced disease involving vagina and parametria with synchronous lung or liver lesions

Fertility-conserving treatment

Results:

Low risk (i.e. LND not required): 27%

22% of high risk patients (i.e. LND required) had positive LN

77% of patients with positive para-aortic mets had them above IMA

Conclusions:

High rate of lymphatic metastasis above the IMA indicates need for pelvic and para-aortic lymphadenectomy (not just sampling) up to renal vessels

Reviewer:
Diana Pearre, OTF