Cripe J, et al. - The objectives of this study were to depict treatment patterns of lymph node staging (LNS), identify factors impacting LNS, and quantify the contemporary trends. Nationally, most patients with greater than 50% myometrial invasion, grades 3 to 4, and/or tumor size greater than 2 cm receive LNS, but this was significantly affected by insurance status, demographic characteristics, and facility location/type.

Methods

• In this study, they queried the National Cancer Data Base for patients going through hysterectomy for endometrioid and serous uterine carcinomas from 2003 to 2012.
• For endometrioid tumors, LNS was considered indicated if not less than 1 of 4 criteria was met.
• Multivariate logistic regression and Cox proportional hazards model were utilized.

Results

• In this study, a total of 161,683 patients were identified who received hysterectomy for 155,893 (96.4%) endometrioid and 5790 (3.6%) serous carcinomas.
• Receipt of LNS was significantly related to greater than 50% myometrial invasion (odds ratio [OR], 1.63; 95% confidence interval [CI], 1.55-1.73), grades 3 to 4 (OR, 3.03; 95% CI, 2.83-3.25), and tumor size greater than 2 cm (OR, 1.17; 95% CI, 1.28-1.26).
• Of the 97,152 patients with endometrioid carcinoma who met criteria for comprehensive staging, 73,268 (75.4%) underwent LNS.
• Patients with endometrioid carcinoma meeting criteria for LNS were less likely to receive LNS if they were of African American race (OR, 0.92; 95% CI, 0.86-0.98), had Medicaid insurance status (OR, 0.75; 95% CI, 0.69-0.81), had Medicare insurance (OR, 0.82; 95% CI, 0.79-0.86), or received care at a community program (OR, 0.39; 95% CI, 0.33-0.46).