{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T17:52:19Z","timestamp":1781632339760,"version":"3.54.5"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T00:00:00Z","timestamp":1769472000000},"content-version":"vor","delay-in-days":5,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100007102","name":"Zagazig University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100007102","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Women's Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Many low-risk endometrial cancer (EC) patients will get no significant benefits from unneeded lymphadenectomy in addition to increasing morbidity and lymphedema risks, which worsen patients\u2019 prognosis. In the present study, we aimed to develop a non-invasive model for the detection of lymph node metastases in endometrial cancer patients using relatively simple clinical predictors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>We included a total of 100 EC patients. We collect the demographic parameters, serologic markers, imaging parameters, and FIGO pathologic staging. Preoperative pathological assessment of the endometrial biopsy was evaluated. We considered grades 1 and 2 endometrioid EC as low-grade endometrial carcinoma (LGEC), and another histological grade as high-grade endometrial carcinoma (HGEC). We correlate between patients with and without lymph node metastases regarding all detected parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 100 patients, 53 had lymph node metastases, and 47 had no lymph node metastases. Radiological evidence of enlarged lymph nodes, large tumor volume, lympho-vascular invasion (LVI), and high levels of serum CA125 (U\/mL) were positively associated with the presence of lymph node metastases (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Patients with pathological evidence of lymph node metastases, who were predicted to have lymph node metastases preoperatively based on clinical and radiological findings, demonstrated less favorable prognostic outcomes compared to those with negative models of prediction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>High serum CA125, enlarged lymph nodes, and large tumor volume were positively associated with the presence of lymph node metastases. While other factors, such as deep myometrial invasion, deep cervical stromal invasion, showed significant associations. This predictive model may assist clinicians in identifying high-risk patients who truly benefit from lymphadenectomy, while sparing low-risk patients from unnecessary procedures and their associated complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12905-025-04249-2","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T07:16:15Z","timestamp":1769066175000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Preoperative clinical predictors of lymph node metastasis in endometrial cancer: a retrospective cohort study"],"prefix":"10.1186","volume":"26","author":[{"given":"Ahmed Metwally","family":"Elkattawy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Mahmoud","family":"Almeniawy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Adel","family":"Saleh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaa","family":"Haggag","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed Elsayed","family":"Mansor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ola A.","family":"Harb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loay M.","family":"Gertallah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amany M.","family":"Abdallah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1978-0858","authenticated-orcid":false,"given":"Mahmood Ahmed","family":"Osman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa","family":"Omara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,22]]},"reference":[{"key":"4249_CR1","first-page":"209","volume":"71","author":"H Sung","year":"2021","unstructured":"Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBO-CAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71:209\u201349.","journal-title":"CA Cancer J Clin"},{"key":"4249_CR2","doi-asserted-by":"publisher","first-page":"1171","DOI":"10.1080\/03007995.2021.1903847","volume":"37","author":"K Akada","year":"2021","unstructured":"Akada K, Koyama N, Miura T, et al. Real-world data base analysis of the characteristics and treatment patterns of patients with endometrial cancer in Japan. Curr Med Res Opin. 2021;37:1171\u20138.","journal-title":"Curr Med Res Opin"},{"key":"4249_CR3","doi-asserted-by":"publisher","first-page":"e76","DOI":"10.3802\/jgo.2017.28.e76","volume":"28","author":"S Shigeta","year":"2017","unstructured":"Shigeta S, Nagase S, Mikami M, et al. Assessing the effect of guideline introduction on clinical practice and outcome in patients with endometrial cancer in japan: a project of the Japan society of gynecologic oncology (JSGO) guideline evaluation committee. J Gynecol Oncol. 2017;28:e76.","journal-title":"J Gynecol Oncol"},{"key":"4249_CR4","first-page":"1","volume":"1","author":"BL Seagle","year":"2017","unstructured":"Seagle BL, Kocherginsky M, Shahabi S. Association of pelvic and para-aortic lymphadenectomy with survival in stage I endometrioid endometrial cancer: matched cohort analyses from the National cancer database. JCO Clin Cancer Inf. 2017;1:1\u201314.","journal-title":"JCO Clin Cancer Inf"},{"key":"4249_CR5","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1016\/j.ygyno.2012.06.035","volume":"127","author":"SC Dowdy","year":"2012","unstructured":"Dowdy SC, Borah BJ, Bakkum-Gamez JN, et al. Prospective assessment of survival, morbidity, and cost associated with lymphadenectomy in low-risk endometrial cancer. Gynecol Oncol. 2012;127:5\u201310.","journal-title":"Gynecol Oncol"},{"key":"4249_CR6","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1016\/j.ygyno.2016.06.004","volume":"142","author":"KH ImaiK","year":"2016","unstructured":"ImaiK KH. A pre-operative risk-scoring system to predict lymph node metastasis in endometrial cancer and stratify patients for lymphadenectomy. Gynecol Oncol. 2016;142:273\u20137.","journal-title":"Gynecol Oncol"},{"key":"4249_CR7","doi-asserted-by":"publisher","first-page":"1290","DOI":"10.1097\/IGC.0000000000001301","volume":"28","author":"M Momtahan","year":"2018","unstructured":"Momtahan M, Hosseini M, Robati M, Najib F. Predictive value of Kana-gawa cancer center scoring system for lymph node metastasis and need for lymphadenectomy in patients with endometrial cancer: a validation study. Int J Gynecol Cancer. 2018;28:1290\u20136.","journal-title":"Int J Gynecol Cancer"},{"key":"4249_CR8","doi-asserted-by":"publisher","unstructured":"Ueno Y, Yoshida E, Nojiri S, Kato T, Ohtsu T, Takeshita T, et al. Use of clinical variables for preoperative prediction of lymph node metastasis in endometrial cancer. Jpn J Clin Oncol. 2024;54(1):38-46. https:\/\/doi.org\/10.1093\/jjco\/hyad135.","DOI":"10.1093\/jjco\/hyad135"},{"key":"4249_CR9","doi-asserted-by":"publisher","first-page":"19004","DOI":"10.1038\/s41598-022-23252-3","volume":"12","author":"Y Asami","year":"2022","unstructured":"Asami Y, Hiranuma K, Takayanagi D, Matsuda M, Shimada Y, Kato M, et al. Predictive model for the preoperative assessment and prognostic modeling of lymph node metastasis in endometrial cancer. 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Oncologist. 2019;24(9):e880\u2013e890.","DOI":"10.1634\/theoncologist.2019-0117"},{"key":"4249_CR14","unstructured":"Guidelines NCCN. Uterine Neoplasms (2018). https:\/\/www2.tri-kobe.org\/nccn\/guide line\/gynecological\/english\/uterine.pdf (2021)."},{"issue":"1","key":"4249_CR15","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1136\/ijgc-2020-002230","volume":"31","author":"N Concin","year":"2021","unstructured":"Concin N, Matias-Guiu X, Vergote I, Cibula D, Mirza MR, Marnitz S, et al. ESGO\/ESTRO\/ESP guidelines for the management of patients with endometrial carcinoma. Int J Gynecol Cancer. 2021;31(1):12\u201339. https:\/\/doi.org\/10.1136\/ijgc-2020-002230.","journal-title":"Int J Gynecol Cancer"},{"issue":"15","key":"4249_CR16","doi-asserted-by":"publisher","first-page":"14159","DOI":"10.1007\/s00432-023-05248-2","volume":"149","author":"C Niu","year":"2023","unstructured":"Niu C, Zhang J, Sun M, Saeed H, Han Y, Okolo PI 3. Maternal and perinatal outcomes of pregnant patients with colorectal cancer: a population-based study. 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The research was conducted in full compliance with the principles of the Declaration of Helsinki. Written informed consent was obtained from all patients prior to their participation in the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"49"}}