Clinical Value of Immunohistochemically Detected Lymphatic and Vascular Invasions in Clinically Staged Endometrioid Endometrial Cancer

Alexander-Sefre, Farhad; Nibbs, Robert J. B.; Rafferty, Teresa; Ayhan, Ayşe; Singh, Naveena; Jacobs, Ian

doi:10.1111/igc.0b013e3181abb0c0

Cited by 21 publications

(18 citation statements)

References 25 publications

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“…More recently, Visser et al 13 conducted a prospective case-control study including 183 patients, and reported that BVI, but not LVI, was an independent poor prognostic factor. In contrast, Alexander-Sefre et al 14 reported that LVI is a better prognostic marker for endometrial cancer progression than BVI. Our results are in line with those by Mannelqvist et al 12 and Visser et al,13 suggesting that BVI is a stronger prognostic factor than LVI in the setting of endometrial cancer undergoing surgery, and considered to add an additional evidence in this field.…”

Section: Discussionmentioning

confidence: 90%

“…Visser et al 13 also reported that BVI, but not LVI, was an independent poor prognostic factor. In contrast, Alexander-Sefre et al 14 reported that LVI is a better prognostic marker for endometrial cancer progression than BVI. However, to our knowledge, these are the only studies to show a significant difference between LVI and BVI in the prognosis of endometrial cancer, and their conflicting findings have left this issue unclear.…”

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confidence: 90%

See 1 more Smart Citation

Blood Vessel Invasion Is a Strong Predictor of Postoperative Recurrence in Endometrial Cancer

Sato¹,

Taguchi

Fukui³

et al. 2018

Int J Gynecol Cancer

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Section: Discussionmentioning

confidence: 90%

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confidence: 90%

Blood Vessel Invasion Is a Strong Predictor of Postoperative Recurrence in Endometrial Cancer

Sato¹,

Taguchi

Fukui³

et al. 2018

Int J Gynecol Cancer

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“…11,19 In studies evaluating all FIGO stages, LVSI has been observed in 8% to 42% of cases. 6Y10, 20 Alexander-Sefre et al 6 found an association between stage and LVSI incidence: LVSI as detected by hematoxylin-eosin staining was not detected in any patients with stage IA disease but was found in 12% and 50% of patients with stages IB and IC disease, respectively. Our results showed no difference in tumor size between patients with and without LVSI among patients with low-risk endometrial cancer.…”

Section: Discussionmentioning

confidence: 98%

“…Other studies have shown a significant difference in the incidence of disease recurrence in patients with LVSI. 6,8 A previous study showed that among patients with recurrence of endometrial cancer, the rate of LVSI ranged from 28.3% to 54%, whereas among patients without recurrence, the rate of LVSI ranged from 10% to 12.6%. 6 In addition, patients with LVSI may present with more distant recurrences 8 and shorter median time from diagnosis to recurrence.…”

Section: Discussionmentioning

confidence: 99%

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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“…An association between MMI and LVSI, detected using hematoxylin-eosin, has been reported; LVSI was not detected in any of the patients with no MMI but was found in 12% with MMI of < 50%, and 50% of patients with MMI of ≥ 50% [27]. This suggests that, as cancer cells infiltrate myometrium, they have progressively greater contact with terminal lymphatic channels, which manifests as increased LVSI positivity on histological inspection [28].…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Lymph Node Metastasis among Lymphovascular Space Invasion-Positive Women with Endometrioid Endometrial Cancer Clinically Confined to the Uterus

et al. 2018

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Introduction: We aimed to assess risk factors for lymph node (LN) metastasis among lymphovascular space invasion(LVSI)-positive women with pure endometrioid endometrial cancer (EC) clinically confined to the uterus. Methods: Medical records of women who underwent primary surgery for EC between 2007 and 2016 at either of 2 gynecological oncology centers were retrospectively reviewed. Patient data were analyzed with respect to LN involvement, and predictive factors for LN metastasis were investigated. Results: 280 patients with surgically staged endometrioid-type EC with LVSI were identified. LN involvement was detected in 88 patients (31.4%) with a systematic LN dissection. In multivariate analysis, elevated baseline serum CA 125 levels, deep myometrial invasion (MMI), adnexal involvement and positive peritoneal cytology were found to be independent risk factors for LN metastasis. In women without deep MMI and elevated baseline serum CA 125 levels, the rate of LN metastasis was 19%. The presence of solely deep MMI increased this probability up to 29.1%. The rate of LN metastasis was found to be 46.8% for women with both deep MMI and elevated baseline serum CA 125 levels. Conclusion: These findings may be useful in the decision-making process for LVSI-positive women who are unstaged.

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Clinical Value of Immunohistochemically Detected Lymphatic and Vascular Invasions in Clinically Staged Endometrioid Endometrial Cancer

Abstract: Lymphatic space invasion detected by using dual immunostaining is of significant value in identifying high-risk patients.

Cited by 21 publications

References 25 publications

Blood Vessel Invasion Is a Strong Predictor of Postoperative Recurrence in Endometrial Cancer

Blood Vessel Invasion Is a Strong Predictor of Postoperative Recurrence in Endometrial Cancer

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

Risk Factors for Lymph Node Metastasis among Lymphovascular Space Invasion-Positive Women with Endometrioid Endometrial Cancer Clinically Confined to the Uterus

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