AccScience Publishing / EJMO / Online First / DOI: 10.36922/EJMO026210226
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ORIGINAL RESEARCH ARTICLE

Clinicopathological determinants of lymph node metastasis and lymphovascular space invasion in endometrial carcinoma: Impact on recurrence-free and overall survival outcomes

Akbar Ibrahimov1* ,  Ahliman Amiraslanov1 ,  Abuzar Gaziyev1 ,  Fidan Novruzova1
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1 Department of Oncology, Faculty of General Medicine, Azerbaijan Medical University, Baku, Azerbaijan
EJMO, 026210226 https://doi.org/10.36922/EJMO026210226
Received: 19 May 2026 | Revised: 29 May 2026 | Accepted: 8 June 2026 | Published online: 22 June 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

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.

Keywords
Endometrial carcinoma
Lymph node metastasis
Lymphovascular space invasion
Disease-free survival
Overall survival
2023 FIGO staging system
Clinicopathological predictors
Funding
None.
Conflict of interest
The authors declare no conflicts of interest.
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Eurasian Journal of Medicine and Oncology, Electronic ISSN: 2587-196X Print ISSN: 2587-2400, Published by AccScience Publishing
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