A nomogram prediction model for lymph node metastasis in endometrial cancer patients

Abstract Background: The determination of lymph node(LN) status is critical for evaluating prognosis and identifying the necessity of adjuvant therapy of endometrial cancer(EC) patients. However, the significance of systematic lymphadenectomy remains controversial. This study aimed to explore the risk factors for lymph node metastasis(LNM) in patients with EC and develop a clinically useful nomogram based on clinicopathological parameters to predict it.Methods: A total of 1517 consecutive patients who underwent staging surgery for EC were abstracted from Qilu Hospital of Shandong University. Parameters including patient-related, tumor-related, and preoperative hematologic examination-related were analyzed by univariate and multivariate logistic regression to determine the correlation with LNM. Based on the multivariate results, a nomogram was constructed and underwent further validation to predict the probability of LNM.Results: The nomogram was constructed and incorporated valuable parameters from the final multivariate model including histological type, histological grade, depth of myometrial invasion, LVSI, cervical involvement, parametrial involvement, and HGB levels. The nomogram was cross-validated internally by the 200 bootstrap sample and showed good discrimination accuracy with an AUC of 0.899.Conclusions: We developed and validated a 7-variable nomogram with a high concordance probability to predict the risk of LNM in patients with EC.