Lymphovascular Space Invasion and the Treatment of Stage I Endometrioid Endometrial Cancer

Putten, Louis J.M. van der; Geels, Yvette P.; Ezendam, Nicole P. M.; Putten, H.W.H.M. van der; Snijders, Marc P.L.M.; Poll‐Franse, Lonneke V. van de; Pijnenborg, Johanna M.A.

doi:10.1097/igc.0000000000000306

Cited by 14 publications

(12 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, it should be emphasized that the prognostic significance of lymphovascular space invasion detected by hematoxylin and eosin, and diagnosed by the primary pathologist, has already been demonstrated in a multicenter study including lymphovascular space invasion-positive patients with stage I endometrioid endometrial cancer 24. By contrast, the absence of quantification of lymphovascular space invasion such as ‘absent’, ‘focal’, and ‘substantial’25 seems to be another important limitation of our study, since substantial lymphovascular space invasion has been reported as a significant factor for recurrence in endometrial cancer 25…”

Section: Discussionmentioning

confidence: 99%

Prognostic significance of lymphovascular space invasion in low-risk endometrial cancer

Ayhan

Şahin

Sarı

et al. 2019

Int J Gynecol Cancer

View full text Add to dashboard Cite

ObjectiveThe purpose of this study was to assess the prognostic significance of lymphovascular space invasion in women with low-risk endometrial cancer.MethodsA dual-institutional, retrospective department database review was performed to identify patients with ‘low-risk endometrial cancer’ (patients having <50% myometrial invasion with grade 1 or 2 endometrioid endometrial cancer according to their final pathology reports) at two gynecologic oncology centers in Ankara, Turkey. Demographic, clinicopathological and survival data were collected.ResultsWe identified 912 women with low-risk endometrial cancer; 53 patients (5.8%) had lymphovascular space invasion. When compared with lymphovascular space invasion-negative patients, lymphovascular space invasion-positive patients were more likely to have post-operative grade 2 disease (p<0.001), deeper myometrial invasion (p=0.003), and larger tumor size (p=0.005). Patients with lymphovascular space invasion were more likely to receive adjuvant therapy when compared with lymphovascular space invasion-negative women (11/53 vs 12/859, respectively; p<0.001). The 5-year recurrence-free survival rate for lymphovascular space invasion-positive women was 85.5% compared with 97.0% for lymphovascular space invasion-negative women (p<0.001). The 5-year overall survival rate for lymphovascular space invasion-positive women was significantly lower than that of lymphovascular space invasion-negative women (88.2% vs 98.5%, respectively; p<0.001). Age ≥60 years (HR 3.13, 95% CI 1.13 to 8.63; p=0.02) and positive lymphovascular space invasion status (HR 6.68, 95% CI 1.60 to 27.88; p=0.009) were identified as independent prognostic factors for decreased overall survival.ConclusionsAge ≥60 years and positive lymphovascular space invasion status appear to be important prognostic parameters in patients with low-risk endometrial cancer who have undergone complete surgical staging procedures including pelvic and para-aortic lymphadenectomy. Lymphovascular space invasion seems to be associated with an adverse prognosis in women with low-risk endometrial cancer; this merits further assessment on a larger scale with standardization of the lymphovascular space invasion in terms of presence/absence and quantity.

show abstract

Section: Discussionmentioning

confidence: 99%

Prognostic significance of lymphovascular space invasion in low-risk endometrial cancer

Ayhan

Şahin

Sarı

et al. 2019

Int J Gynecol Cancer

View full text Add to dashboard Cite

show abstract

“…18 As the probability of lymph-node involvement is low, avoidance of unnecessary lymphadenectomy is mandatory bearing in mind the invasive nature. 18 Considering the current and previous studies, 14,15 it may be that adjuvant RT does not improve recurrence rates in patients with LVSI. This is most likely due to distant recurrences.…”

Section: Discussionmentioning

confidence: 90%

Lymphovascular space invasion in early-stage endometrial cancer: adjuvant treatment and patterns of recurrence

Barneveld

Allen

Bekkers

et al. 2016

Southern African Journal of Gynaecological Oncology

View full text Add to dashboard Cite

In early-stage endometrial cancer, lymphovascular space invasion (LVSI) is an independent predictor of relapse of disease and poorer survival. Nevertheless, adjuvant treatment for LVSI-positive patients is variable. Methods: Early-stage endometrial cancer patients with LVSI, treated in Melbourne between 2000 and 2010, were retrospectively reviewed. Outcomes of patients observed after hysterectomy were compared with those who had had adjuvant EBRT or VBT. Results: A total of 95 patients met the inclusion criteria. After surgery, 40 patients were observed, 48 patients received adjuvant EBRT and 7 adjuvant VBT. Nineteen patients developed recurrent disease (20.0%), of which 12.5% were in the observation group, 27.1% in the EBRT group and 14.3% in the VBT group (p-value 0.217). Fewer vaginal recurrences and more distant recurrences were found in both the RT groups (p-value 0.636 and 0.648 respectively). Multivariate analysis for overall survival (OS) and cancerrelated survival (CRS) revealed a non-significant decrease of hazards in both the radiotherapy (RT) groups when compared with the observation group. Conclusions: In patients with LVSI, adjuvant RT was not shown to reduce recurrence rates or improve OS or CRS. Previous reports have suggested that LVSI may be as important as nodal status for the risk of distant recurrence, therefore the use of systemic therapy should be further investigated.

show abstract

“…20,23,26,27 It has been validated as the (78) strongest independent prognostic factor, 21,28 associated with poor oncological outcomes and reduced survival time. 20,25,29,30 So it should be observed when possible to identify a risk group in which lymphadenectomy and/or adjuvant therapy are beneficial.…”

Section: Discussionmentioning

confidence: 99%

“…29 In 1 study in the Netherlands, in stage I EC with positive LVSI with no lymphadenectomy, radiotherapy (RT) was not enough to prevent distant recurrences. 27 Despite adjuvant therapy with pelvic RT, a significant number of patients still have distant metastases 27,29 ; therefore, adding CT to RT may provide added therapeutic benefit. 34,38 However, its benefit in terms of survival remains controversial in early-stage diseases, and there are no data of its advantage in positive LVSI.…”

Section: Discussionmentioning

confidence: 99%

Lymphovascular Space Invasion for Endometrial Cancer: Undertreatment and Overtreatment Risks

Gorostidi¹,

Noval

Gil-Ibáñez

et al. 2017

Int J Gynecol Cancer

View full text Add to dashboard Cite

Results suggest that LVSI remains a controversial issue in the management of patients with endometrial cancer. Acquiring a deeper knowledge and uniform criteria could avoid the risk of undertreatment and overtreatment in this group of patients with early-stage endometrial cancer. The identification of vascular pseudoinvasion is recommended, although the clinical and prognostic implications still need to be determined.

show abstract

Lymphovascular Space Invasion and the Treatment of Stage I Endometrioid Endometrial Cancer

Cited by 14 publications

References 22 publications

Prognostic significance of lymphovascular space invasion in low-risk endometrial cancer

Prognostic significance of lymphovascular space invasion in low-risk endometrial cancer

Lymphovascular space invasion in early-stage endometrial cancer: adjuvant treatment and patterns of recurrence

Lymphovascular Space Invasion for Endometrial Cancer: Undertreatment and Overtreatment Risks

Contact Info

Product

Resources

About