本研究的目的是确定疑似早期子宫内膜样子宫内膜癌 (EC) 患者中淋巴结 (LN) 转移的高危和低危亚组。 疑似早期子宫内膜样子宫内膜癌 (EC) 患者的临床病理数据 (n= 361）对 2000 年 3 月至 2022 年 7 月期间接受淋巴结切除术治疗的患者进行了分析。在术前磁共振成像（MRI）中，没有患者有明确的淋巴结转移证据。对收到的操作特征曲线进行分析，以确定术前合并淋巴结转移危险因素的敏感性和特异性，这是通过多变量分析确定的。19名患者（5.3%）有淋巴结转移。多变量分析确定 MRI 上有宫颈间质侵犯（优势比 [OR]=4.386；95% 置信区间 [CI]=1.020-18.852；p=0.047），MRI 上肿瘤位于宫角（OR=36.208；95% CI=7.902） -165.913；p<0.001）和 MRI 上肿瘤的子宫下段/峡部位置（OR=8.454；95% CI=1.567-45.610；p=0.013）作为与 LN 转移相关的独立预后因素。根据风险标准将患者分为低风险组和高风险组。两组之间的 LN 转移率存在显着差异（0.4% vs. 22.2%，p<0.001）。大约 95% 的推定早期子宫内膜样 EC 患者没有 LN 转移。使用肿瘤位置的模型与淋巴结转移的风险显着相关。因此，即使在推测的早期子宫内膜样 EC 患者中，也应调查肿瘤位置以确定是否进行 LN 评估。© 2024。亚洲妇科肿瘤学会、韩国妇科肿瘤学会和日本妇科肿瘤学会。

The aim of this study was to identify high- and low-risk subgroups of patients with lymph node (LN) metastasis in presumed early-stage endometrioid endometrial cancer (EC) patients.Clinicopathologic data of presumed early-stage endometrioid EC patients (n=361) treated with lymphadenectomy between March 2000 and July 2022 were analyzed. None of the patient had definite evidence of LN metastasis in a preoperative magnetic resonance imaging (MRI). A received operating characteristic curve analysis was conducted to define the sensitivity and specificity for the combined preoperative risk factors for LN metastasis, which was determined by multivariate analysis.Nineteen patients (5.3%) had LN metastasis. Multivariate analysis identified cervical stromal invasion on MRI (odds ratio [OR]=4.386; 95% confidence interval [CI]=1.020-18.852; p=0.047), cornual location of tumor on MRI (OR=36.208; 95% CI=7.902-165.913; p<0.001), and lower uterine segment/isthmic location of tumor on MRI (OR=8.454; 95% CI=1.567-45.610; p=0.013) as independent prognostic factors associated with LN metastasis. Patients were categorized into low- and high-risk groups according to risk criteria. Significant differences in the rates of LN metastasis were observed between the two groups (0.4% vs. 22.2%, p<0.001).Approximately 95% of presumed early-stage endometrioid EC patients did not have LN metastasis. A model using tumor location was significantly correlated with the risk of LN metastasis. Even in presumed early-stage endometrioid EC patients, therefore, tumor location should be investigated to determine whether to perform LN assessment.© 2024. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology, and Japan Society of Gynecologic Oncology.