Honing the classification of high-risk endometrial cancer with inclusion of lymphovascular space invasion

Bendifallah, Sofiane; Ouldamer, Lobna; Lavoué, Vincent; Canlorbe, Geoffroy; Raimond, Émilie; Hudry, Délphine; Coutant, Charles; Graesslin, Olivier; Touboul, Cyril; Collinet, Pierre; Daraı̈, Émile; Ballester, Marcos

doi:10.1016/j.suronc.2016.11.001

Cited by 10 publications

(10 citation statements)

References 34 publications

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“…These results show that the significance of LVI as a prognostic factor in PLN metastasis development is bigger if the differentiation grade bigger. This was confirmed also by other authors in in their works; Reiz and coworkers and Bendiffalah S et al ( 22 , 23 ).…”

Section: Discussionsupporting

confidence: 87%

Myometrium Invasion, Tumour Size and Lymphovascular Invasion as a Prognostic Factor in Dissemination of Pelvic Lymphatics at Endometrial Carcinoma

Lucic¹,

Draganovic²,

Sibincic³

et al. 2017

Med Arch

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Objective:The aim of this work is to show the importance of the depth of myometrium invasion, tumour size and lymphovascular invasion as prognostic factors in dissemination of lymphatic nodes at endometrial carcinoma (CE).Materials and methods:In the period from 2010 to 2015 at the University Clinic for Gynecology and Obstetrics in Banja Luka, 221 endometrial cancer surgeries were done (laparatomy 184-83%, laparascopy 37-16,74%). Patients who had uterus bleeding in peri/postmenopause or those whose endometrium thickness was bigger than 5 mm which was established by ultrasound, or those who had in their cavum uteri pathological (PH) diagnosis, underwent fractional curettage (FC) or hysteroscopy in order to obtain pathohistological endometrium diagnosis. Substances which were removed by fractional curettage, biopsy or by surgery were sent to patohystological analysis. We analysed the following factors: age (5 groups), histological grade (G) of tumour, depth of myometrial invasion (DIM), whether it is more or less than 50%, the size of the tumour (if it is bigger or smaller than 2 cm), positive or negative lymphovascular invasion (LVI), positive or negative pelvic lymph nodes (PLN).Results:Within histological type the endometrioid type CE 166 (75,11%) was most dominant. Adenocarcinoma of endometrium was present 25 (11,31%), serous CE 11 (4,97%) and clear cell KE 2 (0,90%). Dominant population with CE was over 60 years old 127 (57,46) of female patients. At G3 where DIM was <50% positive PLN were present 2 (3.92%), whereas if DIM was>50%, 6 (26,73%) patients with positive PLN were registred. Tumour size < 2 cm was found with 57 (25,79%) female patients with positive PLN 8 (14,03%), while 164 (74,20%) patients had tumours > 2 cm who had 21 (12,80) PLN metastases. At G1 when tumour was <2 cm, positive PLN had 3 patients (5,88), while when tumour was >2 cm, positive PLN were found at 6 patients (9,69%). At G3 whose size was <2 cm, positive PLN were found at 2 patients (16,66%), but when tumour was >2 cm, PLN metastases were more frequent, 6 (25,00%). Negative LVI was found with 168 patients (76,01%) whose PLN were positive 16 (9,52%), while positive LIV was with 53 patients (23,99%) of whom 14 had PLN metastases (26,41%). At G1 two patients had positive PLN (2,32%) with negative LVI, while with positive LVI, positive PLN were found at 3 patients (11,11%). At G3 having negative LVI positive PLN were found with 6 patients (24,00%), while if LIV was positive, the number of positive PLN were 6 (54,54%).Conclusions:With low risk for lymphatic spread (DIM less than 50%, tumour size smaller than 2 cm and lack of LVI at G1 CE) we also encounter low metastasis rate of PLN. Diagnoses of this kind have an aim to lower the number of pelvic lymphadenectomies. With patients who have a high risk of lymphatic spread (myometrium invasion >50%, tumour size > 2cm, LVI present at G2 and G3) metastasis rate of PLN is high, therefore it is necessary to perform pelvic and paraaortic lymphadenectomy which lowers the mortality rate for more tha...

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Section: Discussionsupporting

confidence: 87%

Myometrium Invasion, Tumour Size and Lymphovascular Invasion as a Prognostic Factor in Dissemination of Pelvic Lymphatics at Endometrial Carcinoma

Lucic¹,

Draganovic²,

Sibincic³

et al. 2017

Med Arch

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“…EC is also classified according to histopathological characteristics with the most common subtypes being endometrioid carcinoma, serous carcinoma, carcino-sarcoma, and clear-cell carcinoma (25). It has been demonstrated that EC comprises a biologically, clinically, morphologically, and genetically heterogeneous behavior especially for the HR group of patients (14,16,26,27).…”

Section: A Clinically and Genetically Heterogeneous Hr Diseasementioning

confidence: 99%

High risk endometrial cancer: Clues towards a revision of the therapeutic paradigm

Bendifallah

Ilenko

Daraı̈

2019

Journal of Gynecology Obstetrics and Human Reproduction

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“…In recent years, with the rapid economic development of China, the incidence of uterine cancer was significantly increased due to changes in people's living habits and diet structure. Furthermore, it has become a serious threat to the health of women, a severe social issue and has a huge financial burden on the country (5,6). The first choice for the treatment of EC is hysterectomy and bilateral salpingo-ophorectomy, while multiple studies have demonstrated that laparoscopic surgery possesses more advantages than laparotomy, including lower degree of blood loss, fewer wound complications and shorter hospital stays (7,8).…”

Section: Introductionmentioning

confidence: 99%

Osthole suppresses the proliferation and induces apoptosis via inhibiting the PI3K/AKT signaling pathway of endometrial cancer JEC cells

Liu

Yang

et al. 2021

Exp Ther Med

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Osthole, a natural product extracted mainly from fruits of Fructus Cnidii, possesses multiple pharmacological functions, including anti-inflammatory, anti-convulsant and anticancer effects. However, the effects of osthole in endometrial cancer (EC) is not fully understood. In the present study, EC cell lines, including JEC, KLE and Ishikawa cells and normal human cervical epithelial cells (HcerEpic) were applied to detect the anticancer effect of osthole. The present study demonstrated that osthole inhibited the proliferation of JEC, KLE and Ishikawa cells, but had no cytotoxic effect on HcerEpic. Furthermore, treatment of osthole induced JEC cell apoptosis, while osthole promoted the release of pro-apoptotic proteins, Bax and activated the cleaved caspase-3, caspase-9 and PARP. Additionally, osthole significantly increased the expression of PETN and decreased the phosphorylated form of PI3K and AKT in a concentration-dependent manner. Furthermore, osthole treatment suppressed the JEC tumor cell growth in a nude mouse xenograft model in vivo, and neither renal toxicity nor hepatotoxicity was induced by the indicated concentration. Taken together, the results of the present study suggested that osthole may be a novel and potential therapeutic agent of EC.

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Honing the classification of high-risk endometrial cancer with inclusion of lymphovascular space invasion

Abstract: LVSI status remains a strong prognostic factor in high-risk ECs associated with a higher recurrence rate and lower RFS and OS whatever the histological type and lymph node status. It could thus be considered in future trials to guide decision-making about adjuvant therapy in high-risk ECs.

Cited by 10 publications

References 34 publications

Myometrium Invasion, Tumour Size and Lymphovascular Invasion as a Prognostic Factor in Dissemination of Pelvic Lymphatics at Endometrial Carcinoma

Myometrium Invasion, Tumour Size and Lymphovascular Invasion as a Prognostic Factor in Dissemination of Pelvic Lymphatics at Endometrial Carcinoma

High risk endometrial cancer: Clues towards a revision of the therapeutic paradigm

Osthole suppresses the proliferation and induces apoptosis via inhibiting the PI3K/AKT signaling pathway of endometrial cancer JEC cells

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