Cervical invasion, lymphovascular space invasion, and ovarian metastasis as predictors of lymph node metastasis and poor outcome on stages I to III endometrial cancers: a single-center retrospective study

Li, Min; Wu, S. C.; Xie, Yangqin; Zhang, Mengjie; Wang, Zhanyu; Zhu, Ying; Yan, S

doi:10.1186/s12957-019-1733-2

Cited by 17 publications

(12 citation statements)

References 37 publications

(43 reference statements)

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“…The pooled result showed that tumor size >20 mm was correlated with high LNM, and the pooled OR was 3.69 (95% CI [2.97, 4.60], p < 0.001), with heterogeneity (I 2 = 0%, p = 0.85). A total of 28,434 patients had FIGO stage III–IV endometrial cancer, based on 21 studies that were enrolled in our meta-analysis ( 15 , 16 , 18 – 20 , 22 – 26 , 28 , 29 , 32 – 36 , 38 – 40 , 45 ). The pooled result showed that tumor size >20 mm was correlated with high LNM, and the pooled OR was 4.32 (95% CI [3.71, 5.03], p < 0.001), with heterogeneity (I 2 = 0%, p = 0.58) ( Figure 5 ).…”

Section: Resultsmentioning

confidence: 99%

Association of Tumor Size With Myometrial Invasion, Lymphovascular Space Invasion, Lymph Node Metastasis, and Recurrence in Endometrial Cancer: A Meta-Analysis of 40 Studies With 53,276 Patients

et al. 2022

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BackgroundMyometrial invasion (MI), lymphovascular space invasion (LVSI), and lymph node metastasis (LNM) have been found to have independent prognostic factors in endometrial cancer. Tumor size has practical advantages in endometrial cancer. The cutoff values for tumor size conformed with current literature. More and more studies inferred that tumor size >20 mm showed a strong correlation. However, the relationship between tumor size >20 mm and MI, LVSI, LNM, recurrence, and overall survival (OS) remains controversial, and no meta-analysis has been conducted. Therefore, a systematic review and meta-analysis should be performed to discuss this issue later on.MethodsRelevant articles were collected from PubMed, EMBASE, and Cochrane Library databases from January 1990 to June 2021. The predictive value of tumor size >20 mm in endometrial cancer was studied, and data were pooled for meta-analysis using Review Manager 5.1. Additionally, the odds ratio (OR) was analyzed, and cumulative analyses of hazard ratio (HR) and their corresponding 95% CI were conducted.ResultsA total of 40 articles with 53,276 endometrial cancer patients were included in the meta-analysis. It contained 7 articles for MI, 6 for LVSI, 21 for LNM, 7 for recurrence, and 3 for OS. Primary tumor size >20 mm was significantly associated with depth of MI (OR = 5.59, 95% CI [5.02, 6.23], p < 0.001), positive LVSI (OR = 3.35, 95% CI [2.34, 4.78], p < 0.001), positive LNM (OR = 4.11, 95% CI [3.63, 4.66], p < 0.001), and recurrence (OR = 3.52, 95% CI [2.39, 5.19], p < 0.001). Tumor size >20 mm was also related to OS via meta-synthesis of HR in univariate survival (HR 2.13, 95% CI [1.28, 3.53], p = 0.003). There was no significant publication bias in this study by funnel plot analysis.ConclusionPrimary tumor size >20 mm was an independent predictive factor for the depth of MI, positive LVSI, positive LNM, recurrence, and poor OS. Therefore, it is more important to take into account the value of tumor size in the clinicopathological staging of endometrial carcinoma. Tumor size >20 mm should be integrated into the intraoperative algorithm for performing a full surgical staging. Well-designed and multicenter studies, with a larger sample size, are still required to verify the findings.

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Section: Resultsmentioning

confidence: 99%

Association of Tumor Size With Myometrial Invasion, Lymphovascular Space Invasion, Lymph Node Metastasis, and Recurrence in Endometrial Cancer: A Meta-Analysis of 40 Studies With 53,276 Patients

et al. 2022

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“…Li et al reported that lymphovascular space invasion was a poor survival risk factor, but this study noted lymphovascular space invasion in multiple stages of endometrial cancer. 15 Cusano et al reported a higher mortality rate in lymphovascular space invasionpositive cases. However, this study only analyzed stage I endometrial cancer cases as a whole, rather than classifying patients into stages IA and IB.…”

Section: Discussionmentioning

confidence: 96%

Is Adjuvant Chemotherapy Necessary in Patients with Early Endometrial Cancer?

et al. 2022

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Background We investigated whether there was a difference in prognosis between patients with stage IA endometrial cancer with and without lymphovascular space invasion. Methods We en rolled patients with stage I A (pT1aN0M0) endometrial cancer admitted to our hospital from 2009 to 2018. All patients underwent hysterectomy, bilateral salpingo-oophorectomy, and systematic pelvic lymphadenectomy. We immunopathologically evaluated the presence or absence of lymphovascular space invasion in the tumor tissue using hematoxylin and eosin, Elastica-van Gieson, and podoplanin staining. We analyzed disease-free and overall survival and calculated patients' survival distribution using the Kaplan-Meier method and log-rank test. The multivariate analysis was performed to determine the prognostic factors.Results A total of 116 patients were included. The median age of the patients was 57 (range, 30-78) years, and the histological subtype revealed 98 and 18 cases of types 1 and 2, respectively. The median follow-up period was 71.9 (range, 10.8-149) months, and the 3-year disease-free and 3-year overall survival rates were 94% and 99%, respectively. The disease-free and overall survival rates were significantly shorter in type 2 patients than in type 1 patients (type 2 vs. type 1; 77% vs. 97%, P < 0.01, 94% vs. 100%, P = 0.014, respectively). The univariate and multivariate analyses showed that there were no significant differences in disease-free survival between the lymphovascular space invasion-positive and -negative groups among type 1 cases. Conclusion There was no difference in prognosis between patients with stage IA and type 1 endometrial cancer with and without lymphovascular space invasion.

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“…The requirement for lymph node dissection was designed according to Mayo criteria; It has been determined that lymph node dissection is not required in cases of ≤ 2 cm tumor size (TD), <1/2 myometrial invasion (MI), and low-grade tumors (12). Otherwise, patients with adequate lymph dissection were included in the study, and it was decided to remove at least 15 pelvic and/or paraaortic lymph nodes for adequate lymph dissection (13,14). All patients were re-evaluated in the gynecologic oncology council before anesthesia examination.…”

Section: Methodsmentioning

confidence: 99%

The Percentage of Peripheral Eosinophils as a Sensitive Marker for Differentiating FIGO Grade in Endometrial Adenocarcinomas

Akış¹,

Öztürk²,

Keleş³

et al. 2022

J Turkish German Gynecol Assoc

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Objective: Studies on eosinophils have mostly been directed to parasitic infections and allergic diseases, but the role of eosinophils in oncology has been largely ignored. Eosinophils are an important modulator of the immune response and components of the inflammatory process against the tumor. This study has been done to reveal the relationship between the data of 318 patients whose final pathology result was reported as a pure endometrioid type endometrial carcinoma (EC) and pre-operative peripheral blood eosinophil percentages. Material and Methods: The data were analyzed in two groups as present/absent according to whether there are tumor metastases in the adnexes, lymph nodes, cervical stroma, and whether there is lymphovascular space invasion. FIGO grade was taken as basis in the evaluation of the tumor grade; Low-grade defines grade 1 or 2, and high-grade defines grade 3. The requirement for lymph node dissection was designed according to Mayo criteria. SPSS software program was used for statistical analysis. Results:The mean percentage of eosinophils in high-grade patients was 2.75 ± 0.35, and it was statistically significantly higher than the mean percentage of eosinophils of 1.79 ± 0.09 found in low-grade patients (p= 0.013). In the ROC analysis, when the cut-off eosinophil percentage was taken as 1.95%, the sensitivity was calculated as 62% and specificity as 67% (p= 0.004). Conclusion:Eosinophil percentages which are a simple, easily accessible, and inexpensive method can be an important pre-operative predictive tool. Eosinophil percentages can be used in determining the need for surgical staging in EC.

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Cervical invasion, lymphovascular space invasion, and ovarian metastasis as predictors of lymph node metastasis and poor outcome on stages I to III endometrial cancers: a single-center retrospective study

Cited by 17 publications

References 37 publications

Association of Tumor Size With Myometrial Invasion, Lymphovascular Space Invasion, Lymph Node Metastasis, and Recurrence in Endometrial Cancer: A Meta-Analysis of 40 Studies With 53,276 Patients

Association of Tumor Size With Myometrial Invasion, Lymphovascular Space Invasion, Lymph Node Metastasis, and Recurrence in Endometrial Cancer: A Meta-Analysis of 40 Studies With 53,276 Patients

Is Adjuvant Chemotherapy Necessary in Patients with Early Endometrial Cancer?

The Percentage of Peripheral Eosinophils as a Sensitive Marker for Differentiating FIGO Grade in Endometrial Adenocarcinomas

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