Zanfagnin V, Huang Y, Mc Gree ME, et al. - Researchers investigated the factors that predict extensive lymphatic dissemination and distant recurrences in node-positive endometrial cancer (EC). For this purpose, they gathered clinicopathologic data from patients who had fully staged EC with at least 1 positive lymph node. They reviewed permanent sections of metastatic lymph nodes; characterization of metastases based on size (≤ 2 mm and > 2 mm) and location in the lymph node (intra- vs extracapsular) was done. They integrated risk factors recognized at multivariate analysis in order to compute the risk of occurrence of multiple pelvic and para-aortic lymph node dissemination. Concomitant presence of multiple positive pelvic nodes, as well as para-aortic node involvement, was reported in correlation with the presence of high-volume metastases in the pelvic lymph nodes. The link of lymphovascular space invasion with both para-aortic node involvement and the occurrence of nonvaginal relapses was also evident. These factors may assist in foretelling the extent of lymphatic dissemination in EC in this era of sentinel lymph node mapping.