Clinicopathological characteristics and possible risk factors for extrauterine metastases in endometrial carcinoma

Abstract

Introduction: Extrauterine metastases often occur in patients with advanced stages of endometrial carcinoma. Retroperitoneal lymph nodes and pelvic lymph nodes are the most common metastatic sites for endometrial carcinoma, while distant metastases, including those to the lung, liver, and brain, are uncommon. This study compares the characteristics of endometrial carcinoma with or without extrauterine metastases and evaluates risk factors associated with extrauterine metastases. Methods: A retrospective analytical study of 155 women with a history of endometrial cancer following complete surgical staging treatment from January 2017 to December 2021 at Dr. Kariadi General Hospital Semarang. All data were obtained using medical records. The clinical and pathological characteristics were compared using the Unpaired T-test and Chi-Square test. Multivariate logistic models were performed to estimate the odds ratio (OR) and 95% CI to analyze independent risk factors for extrauterine metastases. Results A total of 155 endometrial cancer patients were included in this study. Of these, 77 patients have extrauterine metastases (49.67%). The most common site for extrauterine metastases is ovarian metastases (26.5%). Using univariable and bivariate analysis, tumor differentiation grading (OR=3.69, p=0.027) and myometrial invasion (OR=2.84, p=0.027) were the two risk factors associated with extrauterine metastases.  Conclusion: There were significant differences in clinicopathological characteristics between the two groups with and without extrauterine metastases. Tumor differentiation grading and myometrial invasion were two independent risk factors.