Retrospective analysis of prognostic significance of lymph node isolated tumor cells in patients with endometrial cancer

Isolated tumor cells (ITCs) are the histopathological finding of small clusters of cancer cells no greater than 0.2 mm in diameter in the regional lymph nodes. For endometrial cancer, the prognostic significance of ITCs is uncertain. A retrospective cohort study using the National Cancer Database included 56,527 patients with endometrial cancer who had primary hysterectomy and nodal evaluation. Higher T classification, larger tumor size, lymphovascular space invasion, and malignant peritoneal cytology were associated with the presence of ITCs. Overall survival (OS) was different in the low-risk group (stage IA, grade 1-2 endometrioid tumors with absence of lymphovascular space invasion) based on ITCs and adjuvant therapy use. Adjuvant therapy for patients with ITCs was associated with improved OS compared with nonuse. The authors conclude that ITCs may be associated with OS in low-risk endometrial cancer.