{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T16:25:56Z","timestamp":1770740756050,"version":"3.49.0"},"reference-count":39,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2017,4,12]],"date-time":"2017-04-12T00:00:00Z","timestamp":1491955200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002794","name":"Cancerfonden","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002794","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2017,6,15]]},"abstract":"<jats:p>The role of lymphadenectomy in the management of early endometrial cancer remains controversial. In the recent ESMO\u2010ESGO\u2010ESTRO guidelines, lymphadenectomy is recommended for patients with endometrioid adenocarcinoma Grade 3 with deep myometrial invasion, but complete agreement was not achieved. In Sweden, DNA aneuploidy has been included as a high\u2010risk factor. The aim of our study was to evaluate the impact of tumor histology, FIGO grade, DNA ploidy and myometrial invasion (MI) on occurrence of lymph node metastasis (LNM) in patients with endometrial cancer. The study design is a retrospective cohort study based on prospectively recorded register data. Endometrial cancer patients registered in the Swedish Quality Registry for Gynecologic Cancer 2010\u20132015 with FIGO Stages I\u2013III and verified nodal status were included. Data on DNA ploidy, histology, FIGO grade and MI were included in multivariable log\u2010binomial regression analyses with LNM as dependent variable. 1,165 cases fulfilled the inclusion criteria. The multivariable analyses revealed increased risk of LNM in patients with tumors with MI\u2009\u2265\u200950% (risk ratio [RR]\u2009=\u20094.1; 95% confidence interval [CI] 3.0\u20135.6), nonendometrioid compared to endometrioid histology (RR 1.8; CI 1.4\u20132.4) and FIGO Grade 3 compared to Grade 1\u20132 tumors (RR 1.5; CI 1.1\u20132.0). No statistically significant association between DNA ploidy status and LNM was detected. This population\u2010based, nation\u2010wide study in women with endometrial cancer confirms a strong association between MI\u2009\u2265\u200950%, nonendometrioid histology and FIGO Grade 3, respectively, and LNM. DNA ploidy should not be included in the preoperative decision making of removing nodes or not.<\/jats:p>","DOI":"10.1002\/ijc.30707","type":"journal-article","created":{"date-parts":[[2017,3,25]],"date-time":"2017-03-25T09:05:01Z","timestamp":1490432701000},"page":"2693-2700","source":"Crossref","is-referenced-by-count":23,"title":["Risk factors for lymph node metastases in women with endometrial cancer: A population\u2010based, nation\u2010wide register study\u2014On behalf of the Swedish Gynecological Cancer Group"],"prefix":"10.1002","volume":"140","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5527-8796","authenticated-orcid":false,"given":"K.","family":"St\u00e5lberg","sequence":"first","affiliation":[{"name":"Department of Women's and Children's Health Uppsala University Uppsala Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Kj\u00f8lhede","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Link\u00f6pings Universitet Link\u00f6ping Sweden"},{"name":"Department of Clinical and Experimental Medicine Link\u00f6pings Universitet Link\u00f6ping Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Bjurberg","sequence":"additional","affiliation":[{"name":"Department of Hematology Oncology, and Radiation Physics, Skanes Universitetssjukhus, Lund  Sweden"},{"name":"Division of Oncology and Pathology Department of Clinical Sciences, Lunds Universitet Lund Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Borgfeldt","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Sk\u00e5ne University Hospital, Lund University Lund Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Dahm\u2010K\u00e4hler","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Sahlgrenska Academy at University of Gothenburg Gothenburg Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.","family":"Falconer","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Holmberg","sequence":"additional","affiliation":[{"name":"Regional Cancer Center Western Sweden, Sahlgrenska Universitetssjukhuset Gothenburg Sweden"},{"name":"Institute of Clinical Sciences, Goteborgs Universitet Sahlgrenska Akademin G\u00f6teborg Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Staf","sequence":"additional","affiliation":[{"name":"Sahlgrenska Universitetssjukhuset, Regional Cancer Center Western Sweden G\u00f6teborg Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.","family":"Tholander","sequence":"additional","affiliation":[{"name":"Department of Oncology Uppsala University Hospital Uppsala Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"\u00c5vall\u2010Lundqvist","sequence":"additional","affiliation":[{"name":"Department of Oncology Link\u00f6pings University Link\u00f6ping Sweden"},{"name":"Department Clinical and Experimental Medicine Link\u00f6pings University Link\u00f6ping Sweden"},{"name":"Department of Oncology and Pathology Karolinska Institutet Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Rosenberg","sequence":"additional","affiliation":[{"name":"Department of Oncology H\u00f6gberg Universitetssjukhuset i Link\u00f6ping Link\u00f6ping Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"H\u00f6gberg","sequence":"additional","affiliation":[{"name":"Department of Cancer Epidemiology Sk\u00e5ne University Hospital, Lund University Lund Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,4,12]]},"reference":[{"key":"e_1_2_10_2_1","first-page":"1305","article-title":"Overall survival and disease\u2010free survival in endometrial cancer: prognostic factors in 276 patients","volume":"9","author":"Tejerizo\u2010Garcia A","year":"2013","journal-title":"Onco Targets Ther"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.3892\/ol.2016.4918"},{"key":"e_1_2_10_4_1","first-page":"CD007585","article-title":"Lymphadenectomy for the management of endometrial cancer","author":"Frost JA","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_10_5_1","unstructured":"Network NCC. 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