Risk factors for cervical stromal involvement in endometrioid-type endometrial cancer.

Objective The aim of this study was to identify predictors of cervical stromal involvement in women with endometrioid-type endometrial cancer (EEC). Methods A total of 795 patients with EEC who underwent comprehensive surgical staging including pelvic and para-aortic lymph node dissection between January 2007 and December 2018 were retrospectively analyzed. Data including age, menopausal status, serum CA-125 levels, tumor size, lymphovascular space invasion (LVSI), depth of myometrial invasion, positive peritoneal cytology, cervical stromal involvement, histological grade, recurrence, and follow-up duration were recorded. Results Median follow-up was 49 months. Cervical stromal invasion was found in 88 patients. Multivariate analysis revealed that presence of LVSI (HR: 2, 95% CI, 1.017 - 4.254, p=0.045), a primary tumor diameter of ≥3 cm (HR: 3, 95% CI, 1.315 - 7.254, p=0.010), and ≥50% deep myometrial invasion (HR: 2.7, 95% CI, 1.368 - 5.409, p=0.004) were independent risk factors for cervical stromal involvement in patients with EEC. Conclusion Our study results suggest that presence of LVSI, a primary tumor diameter of ≥3 cm, and LVSI of ≥50% seem to be independent predictors of cervical involvement in patients with EEC.