Akbar IBRAHIMOV, Ahliman AMIRASLANOV, Abuzar GAZIYEV, Fidan NOVRUZOVA
Eurasian Journal of Medicine and Oncology - 2026;10(4):1-20
Introduction: Lymph node metastasis (LNM) and lymphovascular space invasion (LVSI) are established prognostic markers in endometrial carcinoma (EC), yet their clinicopathological determinants and prognostic impact remain incompletely characterized in underrepresented regional populations. Objective: This study aims to identify predictors of LNM and LVSI and their influence on disease-free survival (DFS) and overall survival (OS) in EC patients. Methods: A retrospective cohort of 462 histologically confirmed EC patients who underwent primary surgical staging at Azerbaijan Medical University was analyzed. Fisher's exact test, Student's t-test, and the Mann-Whitney U test were used for between-group comparisons. Univariate logistic regression was used to assess associations with LNM and LVSI. Kaplan-Meier methodology and univariate Cox proportional hazards regression were applied to DFS and OS. An exploratory multivariate Cox model was constructed for each endpoint using variables selected a priori based on clinical relevance and univariate significance ( p < 0.05). Results: LNM was present in 17.6% of patients undergoing lymphadenectomy; LVSI in 22.7% with known status. Non-endometrioid histology, grade III differentiation, myometrial invasion > 50%, serosal extension, cervical involvement, and adnexal spread were each independently associated with LNM and LVSI. In exploratory multivariate analysis, grade III independently predicted shorter DFS (hazard ratio [HR] = 2.24; 95% CI: 1.03-4.90; p = 0.043) and LNM predicted shorter OS (HR = 2.39; 95% CI: 1.06-5.39; p = 0.035); both findings should be considered hypothesis-generating. Conclusion: Adverse clinicopathological features, including high histological grade, non-endometrioid subtype, deep myometrial invasion, and locoregional extension, are significant predictors of LNM and LVSI. These findings support their systematic incorporation into perioperative risk stratification. Prospective studies with molecular profiling and extended follow-up are warranted.
