Risk factors and prognostic analysis of endometrial cancer with para-aortic lymph node metastasis

Para-aortic lymph node (PAN) metastasis is rare in early-stage, low-risk endometrial cancer, and routine dissection may be safely omitted. However, para-aortic lymphadenectomy remains essential for patients with high-risk features, such as non-endometrioid histology, lymphovascular space invasion (LVSI), pelvic node metastasis, and elevated CA125 levels. Notably, uterine serous carcinoma is associated with frequent nodal spread and poor five-year survival.