Endometrial Cancer Mayo Lymphadenectomy Indication — free guideline decision tool

Use the Mayo criteria (histology, grade, myometrial invasion, tumour size) to judge whether an endometrioid adenocarcinoma can safely be spared lymphadenectomy. Instant, browser-side.

Low-risk = endometrioid, G1–2, myometrial invasion ≤ 50%, diameter ≤ 2 cm (or no myometrial invasion at any size/grade). Any of G3 / > 50% invasion / > 2 cm / non-endometrioid = at-risk.

Identify the low-risk endometrioid endometrial cancer group that can omit systematic lymphadenectomy.

The low-risk group has roughly 1–5% nodal metastasis and ~ 99% 5-year survival, and can omit systematic dissection without a survival cost. The at-risk group has roughly 6.4% nodal metastasis and warrants pelvic ± para-aortic dissection or sentinel-node biopsy. Non-endometrioid histology (serous/clear-cell/carcinosarcoma) is high-risk regardless and needs full staging. Contemporary practice increasingly replaces systematic lymphadenectomy with sentinel-node mapping.

For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.

Inputs: Histology Endometrioid adenocarcinoma, Grade G1–2, Myometrial invasion depth No myometrial invasion (0%), Maximum primary tumour diameter ≤ 2 cm → Result: Lymphadenectomy Can be omitted（Verdict: Low-risk: Endometrioid, no myometrial invasion (0%) — low-risk at any size/grade (nodal metastasis ~ 1–5%, 5-year survival ~ 99%), Management direction: Systematic pelvic/para-aortic lymphadenectomy can be safely omitted (no survival impact); sentinel-node mapping now commonly replaces it, Notes: Mayo criteria (Mariani 2000/2008): low-risk = endometrioid, G1–2, myometrial invasion ≤ 50%, diameter ≤ 2 cm (or no myometrial invasion, any size/grade); high-risk (> 50% invasion / G3 / > 2 cm / non-endometrioid) needs node assessment. Contemporary practice often replaces systematic dissection with sentinel-node biopsy） Inputs: Histology Non-endometrioid (serous/clear-cell/carcinosarcoma etc.), Grade G3, Myometrial invasion depth > 50% (outer half), Maximum primary tumour diameter > 2 cm → Result: Lymphadenectomy Dissection/assessment advised（Verdict: High-risk (at-risk): Non-endometrioid (serous/clear-cell/carcinosarcoma etc.) is high-risk histology and needs systematic staging / node assessment (nodal metastasis ~ 6.4%), Management direction: Systematic pelvic ± para-aortic lymphadenectomy is advised, or sentinel-node biopsy to complete staging, Notes: Mayo criteria (Mariani 2000/2008): low-risk = endometrioid, G1–2, myometrial invasion ≤ 50%, diameter ≤ 2 cm (or no myometrial invasion, any size/grade); high-risk (> 50% invasion / G3 / > 2 cm / non-endometrioid) needs node assessment. Contemporary practice often replaces systematic dissection with sentinel-node biopsy）