IMPACT OF TUMOR SITE ON LYMPH NODE METASTASIS AND SURVIVAL OUTCOMES IN CARCINOMA ENDOMETRIUM: A RETROSPECTIVE SINGLE- INSTITUTION STUDY

Abstract

Background: Tumor location within the uterus may influence lymphatic spread and prognosis in endometrial carcinoma. Understanding these patterns is essential for risk stratification and tailoring treatment strategies.

Objective: To evaluate the relationship between primary tumor site in the endometrial cavity and its association with lymph node metastasis, clinicopathological characteristics, and survival outcomes in patients undergoing curative-intent treatment.

Methods: This retrospective study included 156 patients with non-metastatic carcinoma endometrium who underwent curative surgery at a tertiary care center between January 2016 and December 2020. Clinicopathological features, tumor site, nodal status, and survival data were analyzed. Statistical analysis was performed using SPSS version 29.0.

Results: Mean patient age was 57.65±9.24 years. Most tumors (66%) were endometrioid histology. Tumors involving the lower uterine segment (LUS) were more common in younger, premenopausal women and were associated with high-grade histology, increased lymphovascular space invasion (LVSI), deep myometrial invasion, cervical involvement, and advanced FIGO stage. Lymph node metastasis was observed in 14% of cases. Mean overall survival was highest in fundal tumors (94.6 months) and lowest in LUS tumors (74.3 months). Disease-free survival followed a similar trend.

Conclusion: Lower uterine segment involvement is associated with aggressive pathological features and poorer survival outcomes in endometrial cancer. Tumor location should be considered in prognostic evaluation and treatment planning.