Preoperative CT evaluation of pelvic and paraaortic lymph node metastases in endometrial cancer

This study evaluated the usefulness of computed tomography (CT) in the diagnosis of pelvic and paraaortic lymph node metastases. Study subjects were 52 patients with endometrial carcinoma (31 in Stage Ia, 9 in Stage Ib, 7 in Stage II, 4 in Stage III, one in Stage IV) who underwent systemic lymph node dissection after preoperative pelvic and upper abdominal CT. CT findings were reviewed and compared with histologically confirmed findings. The sensitivity and specificity of CT were 75.0% (6/8) and 95.5% (42/44) in the diagnosis of pelvic lymph node metastases and 57.1% (4/7) and 100% (32/32) in the diagnosis of paraaortic lymph node metastases. Of 8 patients with histologically proven lymph node metastases, 7 (12.5%) had macroscopical metastases and the other one had micrometastasis (12.5%). Twelve lymph nodes were found to be enlarged on biopsy, and 5 of these (41.7%) were reactive hyperplasia with no evidence of metastases. CT had a 50.0% sensitivity and 95.0% specificity in diagnosing pelvic lymph node enlargement. These findings suggest that CT may be helpful in the diagnosis of pelvic and paraaortic lymph node metastases. (N.K.)