Association between tumor diameter and lymphovascular space invasion among women with early-stage endometrial cancer

Laufer, J; Scasso, Santiago; Papadia, Andrea; Sosa, Claudio; Cirillo, Federico; Raspagliesi, Francesco

doi:10.1016/j.ijgo.2013.05.012

Cited by 35 publications

(31 citation statements)

References 20 publications

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“…9 Our finding that patients with LVSI had higher preoperative and postoperative pathologic grade than did patients without LVSI is consistent with previous series. 4 found that in patients with lymph nodeYnegative disease, the presence of LVSI may be a more powerful prognostic marker than grade and histologic type.…”

Section: Discussionsupporting

confidence: 92%

Lymphovascular Space Invasion Portends Poor Prognosis in Low-Risk Endometrial Cancer

Reis

Burzawa

Tsunoda

et al. 2015

Int J Gynecol Cancer

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Objective The prognostic significance of lymphovascular space invasion (LVSI) in patients with early-stage endometrial cancer is not established. We sought to determine if LVSI status in patients with early-stage low-risk endometrial cancer correlates with recurrence and survival. Methods The records of all women who underwent hysterectomy for primary treatment of endometrial cancer from January 2006 through January 2011 at one academic institution were reviewed. Patients with grade 1 or 2 endometrioid histology, myometrial invasion less than 50%, and disease confined to the uterus (clinical FIGO stage IA) were analyzed. Fisher’s exact test and the Wilcoxon rank-sum test were applied to compare patients with and without LVSI. Recurrence-free survival (RFS) and overall survival (OS) were calculated using the Kaplan-Meier method. Results Two hundred forty patients met the inclusion criteria. Forty (16.7%) had LVSI. Ninety-one patients (37.9%) underwent lymphadenectomy. Median tumor size was 30 mm in patients with and 26 mm in patients without LVSI (p=0.150). Thirty patients (12.5%) received adjuvant therapy. Site of recurrence did not differ between patients with and without LVSI. Patients with LVSI were more likely to have myometrial invasion (p<0.001), postoperative pathologic grade 2 disease (p<0.001), to undergo lymphadenectomy (p=0.049) and receive adjuvant therapy (p<0.001). The 5-year cumulative incidence of recurrence was 3.8% in the no-LVSI group and 14.2% in the LVSI group (p=0.053). The presence of LVSI was significantly associated with worse RFS (p=0.002) and OS (p=0.013). Conclusion Patients with low-risk endometrial cancer and LVSI have worse RFS and OS despite being more likely to undergo lymphadenectomy and adjuvant therapy.

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Section: Discussionsupporting

confidence: 92%

Lymphovascular Space Invasion Portends Poor Prognosis in Low-Risk Endometrial Cancer

Reis

Burzawa

Tsunoda

et al. 2015

Int J Gynecol Cancer

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“…In an analysis of more than 300 endometrioid EC patients with FIGO grade 1 or 2 and myometrial invasion limited to the inner half, we found that no patients with tumor diameter of 2 cm or less had positive lymph nodes or lymph node recurrences or died of disease . This finding has been recently prospectively validated by our group and others …”

Section: Clinical Considerationssupporting

confidence: 71%

Role of pelvic and para‐aortic lymphadenectomy in endometrial cancer: Current evidence

Bogani

Dowdy

Cliby

et al. 2014

J of Obstet and Gynaecol

169

122

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The aim of the present review is to summarize the current evidence on the role of pelvic and para-aortic lymphadenectomy in endometrial cancer. In 1988, the International Federation of Obstetrics and Gynecology recommended surgical staging for endometrial cancer patients. However, 25 years later, the role of lymph node dissection remains controversial. Although the findings of two large independent randomized trials suggested that pelvic lymphadenectomy provides only adjunctive morbidity with no clear influence on survival outcomes, the studies have many pitfalls that limit interpretation of the results. Theoretically, lymphadenectomy may help identify patients with metastatic dissemination, who may benefit from adjuvant therapy, thus reducing radiation-related morbidity. Also, lymphadenectomy may eradicate metastatic disease. Because lymphatic spread is relatively uncommon, our main effort should be directed at identifying patients who may potentially benefit from lymph node dissection, thus reducing the rate of unnecessary treatment and associated morbidity. This review will discuss the role of lymphadenectomy in endometrial cancer, focusing on patient selection, extension of the surgical procedure, postoperative outcomes, quality of life and costs. The need for new surgical studies and efficacious systemic drugs is recommended.

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“…Considering the correlation between patient age and LVSI status, it is seen that there are publications which found both significant [3,33] and insignificant [27] correlations. Significant correlations have been reported between tumour size, [34,19] histological grade [19,33], and myometrial invasion [19,20,33]. These, along with the LUSI and LVSI statuses of patients, affect the decision to proceed with intraoperative lymphadenectomy in endometrial cancer surgery.…”

Section: Discussionmentioning

confidence: 99%

Lower uterine segment involvement in lymphovascular space invasion and lymph node metastasis in endometrioid endometrial cancer

Çökmez

Yılmaz

2019

Ginekol Pol

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Objectives: To evaluate the correlation between lymphovascular space invasion (LVSI) indicating lower uterine segment involvement (LUSI) in endometrioid endometrial cancer and lymph node metastasis based on the lymphatic drainage difference between the uterine corpus and the lower segment. Material and methods: Patients who underwent staging surgery for endometrioid endometrial cancer between January 2010 and January 2019 at our institution were reviewed. The clinicopathologic findings and LUSI status of the patients were compared with their LVSI and lymph node metastasis status. Results: Of the 253 patients included in this study, 49 (19.4%) had LUSI. Among these patients, none of the 31 LVSI-negative patients had metastatic lymph node involvement. However, of the 18 LVSI-positive patients, half had metastatic lymph node involvement; this difference was significant (p < 0.05). Conclusions: The significant correlation between LVSI and lymph node metastasis in LUSI-positive cases indicates that pathologists should also focus on LVSI findings in the frozen examination required for the decision of staging surgery in patients with endometrioid endometrial cancer limited to the uterus. This is especially important in patients with a lower uterine segment involvement.

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Association between tumor diameter and lymphovascular space invasion among women with early-stage endometrial cancer

Cited by 35 publications

References 20 publications

Lymphovascular Space Invasion Portends Poor Prognosis in Low-Risk Endometrial Cancer

Lymphovascular Space Invasion Portends Poor Prognosis in Low-Risk Endometrial Cancer

Role of pelvic and para‐aortic lymphadenectomy in endometrial cancer: Current evidence

Lower uterine segment involvement in lymphovascular space invasion and lymph node metastasis in endometrioid endometrial cancer

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