Prognostic value of lymphovascular space invasion in early-stage cervical cancer

Weyl, Ariane; Illac, Claire; Lusque, Amélie; Leray, Hélène; Vaysse, Charlotte; Martinez, Alejandra; Chantalat, Élodie; Motton, Stéphanie

doi:10.1136/ijgc-2020-001274

Cited by 14 publications

(8 citation statements)

References 24 publications

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“…Typically, lymph node metastasis [27] and lymphovascular space invasion [28] are important factors affecting tumor survival, but by multivariate analysis of this series, such a negative impact was not found. In addition, our department would also refer to the Ki67 index in immunohistochemistry.…”

Section: Discussionmentioning

confidence: 94%

Preoperative Conization May Have a Positive Impact on Survival in Early-Stage Cervical Cancer: A Propensity-Matched Study

Gong

et al. 2021

Oncol Res Treat

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Introduction: A recent prospective randomized study demonstrated that minimally invasive surgery (MIS) was inferior to open surgery in disease survival in early-stage cervical cancer. Our aim was to investigate whether there were survival benefits of preoperative conization prior to MIS for early-stage cervical cancer. Methods: We retrospectively analyzed patients who eventually underwent definitive MIS with stage IA2 to IB1 (no >2 cm) squamous cell carcinoma, adenocarcinoma, and adenosquamous carcinoma. Preoperatively, the patients were separated into 2 groups: one managed with conization and the other undergoing biopsy without conization. Propensity scoring weight and matching were used to reduce the influence of possible allocation biases. The Cox regression model was used for univariate and multivariate analyses of disease recurrence and survival. Results: 227 patients were contained in this study (99 patients in the conization group and 128 patients in the nonconization group). The 5-year DFS of the conization group was statistically better than that of the nonconization group (98.4% vs. 91.8%, p = 0.011). By univariate analysis, conization (HR = 0.11, 95% CI = 0.01–0.87, p = 0.03) and histologic cell type (p = 0.01) were considered as risk factors for recurrence. Multivariate analysis further confirmed conization (HR = 0.04, 95% CI = 0.01–0.51, p = 0.01) and histologic cell type (p < 0.01) correlated with DFS. After propensity score matching (1:1), 84 patients were included in the conization and nonconization groups, respectively, with 5-year DFS still higher in the conization group (98.3% vs. 92.9%, p = 0.037). The results after univariate and multivariate analyses were consistent with those prior to propensity score matching. Conclusion: Preoperative conization in conjunction with MIS seemed to be a safe and feasible approach, with results that may have implications for the reduction of recurrence. Histologic cell type also impacted survival. Therefore, more future prospective studies are warranted.

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Section: Discussionmentioning

confidence: 94%

Preoperative Conization May Have a Positive Impact on Survival in Early-Stage Cervical Cancer: A Propensity-Matched Study

Gong

et al. 2021

Oncol Res Treat

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“…In the present study, high tumor AKIP1 protein expression was independently associated with decreased OS time in the patients with endometrial carcinoma. Possible reasons to explain these findings, as suggested by previous studies, were: i) Elevated tumor AKIP1 expression promoting endometrial carcinoma cell invasion and migration through the mediation of multiple pathways (such as the Akt/GSK-3β and PI3K/Akt pathways), thus leading to an enhanced risk of tumor recurrence and an unfavorable prognosis in patients with endometrial carcinoma (7,27,28). ii) As illustrated in the present in vitro study, silencing of AKIP1 enhanced the chemosensitivity to cisplatin and paclitaxel in an endometrial carcinoma cell line, thus its overexpression may decrease the postoperative chemosensitivity, thereby leading to an unfavorable prognosis in patients with endometrial carcinoma.…”

Section: Discussionmentioning

confidence: 95%

Elevated AKIP1 expression is associated with tumor invasion, shorter survival time and decreased chemosensitivity in endometrial carcinoma

Gao

et al. 2022

Oncol Lett

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A-kinase-interacting protein 1 (AKIP1), as a recently discovered oncoprotein, promotes cell malignant behaviors in gynecological malignancies. To the best of our knowledge, no study reports its clinical value in patients with endometrial carcinoma. The present study aimed to explore the association between AKIP1 expression and clinical features and survival in patients with endometrial carcinoma, and to assess the effect of AKIP1 knockdown on the regulation of chemosensitivity in vitro. The tumor and adjacent tissue specimens from 101 patients with endometrial carcinoma were retrieved for AKIP1 protein expression analysis using an immunohistochemistry (IHC) assay. Meanwhile, specimens from 54 patients with endometrial carcinoma were analyzed for AKIP1 mRNA expression using reverse transcription-quantitative PCR. Furthermore, an in vitro experiment was conducted in the Ishikawa cell line to determine the effect of AKIP1 modification on the chemosensitivity of cisplatin and paclitaxel. AKIP1 IHC score (P<0.001) and mRNA expression levels (P<0.001) were increased in tumor tissues compared with those in adjacent tissues. Moreover, increased AKIP1 IHC score was associated with lymphovascular invasion (P=0.007), advanced International Federation of Gynecology and Obstetrics (FIGO) stage (P=0.002) and shorter overall survival (OS) time (P=0.035) in the patients with endometrial carcinoma. Meanwhile, upregulated AKIP1 mRNA expression levels were associated with lymphovascular invasion (P=0.020) and advanced FIGO stage (P=0.027) in the patients with endometrial carcinoma. Multivariate Cox regression showed that tumor AKIP1 protein expression (high vs. low) independently predicted a shorter OS time (P=0.036). Silencing of AKIP1 decreased Ishikawa cell viability when treated with 5, 10, 20 and 40 µM cisplatin (all P<0.05) and decreased the half maximal inhibitory concentration value of cisplatin (P=0.003), whereas its effect on paclitaxel chemosensitivity was less obvious. Overall, elevated AKIP1 expression was associated with tumor invasion, shorter survival time and decreased chemosensitivity in endometrial carcinoma.

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“…This may be explained by the fact that the starting point of the AIF in model-based DCE-MRI evaluation is usually a larger upstream artery of the tumor, 39 while vascular invasion of cervical cancer usually occurs in the small blood vessels inside and around the tumor. 40 Therefore, some microvascular invasion may be underestimated. Furthermore, the invasion of lymphatic vessels of cervical cancer may be ignored in DCE-MRI-derived parameters.…”

Section: Discussionmentioning

confidence: 99%

Preliminary MRI Study of Extracellular Volume Fraction for Identification of Lymphovascular Space Invasion of Cervical Cancer

Wang

Fan

Yang

et al. 2022

Magnetic Resonance Imaging

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Background: Lymphovascular space invasion (LVSI) is a risk factor for poor prognosis of cervical cancer. Preoperative identification of LVSI is very difficult.Purpose: To evaluate the potential of extracellular volume (ECV) fraction based on T1 mapping in preoperative identification of LVSI in cervical cancer compared with dynamic contrast-enhanced MRI (DCE-MRI). Study Type: Retrospective. Subjects: A total of 79 patients (median age 54 years) with cervical cancer were classified into LVSI group (n = 29) and without LVSI group (n = 50) according to postoperative pathology. Field Strength/Sequence: A 3-T, noncontrast and contrast-enhanced T1 mapping performed with volume interpolated breath hold examination (VIBE) sequence, DCE-MRI applied with 3D T1-weighted VIBE sequence. Assessment: Regions of interest along the medial edge of the lesion were drawn on slices depicting the maximum crosssection of the tumor. The noncontrast and contrast-enhanced T1 value of the tumor and arteries in the same slice were measured, and ECV was calculated from T1 values. The parametric maps (K trans , k ep , and v e ) derived from DCE-MRI standard Toft's model were evaluated. Statistical Tests: ECV, K trans , k ep , and v e between groups with and without LVSI were compared using Student's t-test. The receiver operating characteristic (ROC) curve and DeLong test were used to evaluate and compare the diagnostic performance of ECV, K trans , k ep , and v e for differentiating LVSI. P < 0.05 was considered statistically significant. Results: The ECV and K trans of the LVSI group were significantly higher than that of non-LVSI group (52.86% vs. 36.77%, 0.239 vs. 0.176, respectively), and no significant differences in K ep or v e values were observed (P = 0.071 and P = 0.168, respectively). The ECV fraction showed significantly higher area under ROC curve than K trans for differentiating LVSI (0.874 vs. 0.655, respectively). Data Conclusion: ECV measurements based on T1 mapping might improve the discrimination between patients with and without LVSI in cervical cancer, showing better performance for this purpose than DCE-MRI.

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Prognostic value of lymphovascular space invasion in early-stage cervical cancer

Cited by 14 publications

References 24 publications

Preoperative Conization May Have a Positive Impact on Survival in Early-Stage Cervical Cancer: A Propensity-Matched Study

Preoperative Conization May Have a Positive Impact on Survival in Early-Stage Cervical Cancer: A Propensity-Matched Study

Elevated AKIP1 expression is associated with tumor invasion, shorter survival time and decreased chemosensitivity in endometrial carcinoma

Preliminary MRI Study of Extracellular Volume Fraction for Identification of Lymphovascular Space Invasion of Cervical Cancer

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