Whether intermediate-risk stage 1A, grade 1/2, endometrioid endometrial cancer patients with lesions larger than 2 cm warrant lymph node dissection?

Zhu, Menghan; Nan, Jun; Huang, Feifei; Liu, Xiaoxia; Zhao, Yuqing; Tao, Xiang; Jiang, Wei; Li, Qin; Feng, Weiwei

doi:10.1186/s12885-017-3671-0

Cited by 14 publications

(18 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As our study lacks immunohistochemical studies such as cytokeratin and D2-40,28 29 the true overall rate of lymphovascular space invasion-positive tumors might have been underestimated in the current study. However, the rate of lymphovascular space invasion-positive tumors was reported to be only 2.2% (18/818) in a recent study by Zhu et al30 It should be noted that central pathology review was performed in the Zhu study 30…”

Section: Discussionmentioning

confidence: 91%

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: 91%

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

“…Relevant data from China is quite limited, but several researches published recently supported our findings. Zhu et al [26] in their paper analyzed 624 Chinese EEC patients with intermediate risk (grade 1-2, myometrial invasion <50%, tumor diameter <2 cm). Interestingly, though LVSI was found to be associated with LNM, all 15 cases with subsequent recurrence in this cohort were negative for LVSI.…”

Section: Lvsi In Endometrioid Endometrial Cancermentioning

confidence: 99%

Prognostic significance of lymphovascular space invasion in patients with endometrioid endometrial cancer: a retrospective study from a single center

et al. 2020

View full text Add to dashboard Cite

Objective: This study aims to analyze factors associated with lymphovascular space invasion (LVSI) and evaluate the prognostic significance of LVSI in Chinese endometrioid endometrial cancer (EEC) patients. Methods: Five-hundred eighty-four EEC patients undergoing surgery in our center from 2006 to 2016 were selected for analysis. Univariate analysis and multivariate logistic regression were used to examine relevant factors of LVSI. To evaluate the prognostic role of LVSI, survival analyses were conducted. In survival analyses, both multivariate Cox regression and propensity score matching were used to control the confounders. Results: The incidence of LVSI was 12.16% (71/584). Diabetes history (p=0.021), lymph node metastasis (p=0.005), deep myometrial invasion (p<0.001) and negative PR expression (p=0.007) were independently associated with LVSI. Both Kaplan-Meier method and univariate Cox regressions showed LVSI negative and positive cases had similar tumorspecific survival (TSS) and disease-free survival (DFS). After adjusting for the influence of adjuvant therapy and other clinicopathological factors with multivariate Cox regressions, LVSI still could not bring additional survival risk to the patients (p=0.280 and p=0.650 for TSS and DFS, respectively). This result was verified by Kaplan-Meier survival analyses after propensity score matching (p=0.234 and p=0.765 for TSS and DFS, respectively). Conclusion: LVSI does not significantly compromise the survival outcome of Chinese EEC patients.

show abstract

“…For the low-risk group, FIGO 2009 (19) and National Comprehensive Cancer Network (NCCN) 2016 identify tumour diameter as an important pathological feature in addition to those in ESMO-ESGO-ESTRO 2016 (Table 3). A 2017 study also incorporated tumour size of less than 2cm into its risk stratification system, however this was not found to be an independent prognostic factor (12,22) . Without a standardised approach, this poses difficulty both in the clinical setting and when comparing clinical trials.…”

Section: Table 2 | This Table Was Adapted By the Authors Frommentioning

confidence: 99%

“…The standard treatment of EC is total hysterectomy, bilateral salpingo-oophorectomy and in some cases systematic lymph node dissection (LND). LND is the surgical removal of lymph nodes (12) . Complete surgical staging, including LND is considered the gold standard method of evaluating lymph node status (7,13,14) .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The role of lymph node dissection in endometrial cancer: a systematic scoping review.

Kufour¹,

Thornton-Wood²,

Allen³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Surgical staging including lymph node dissection (LND) is considered the gold standard method of evaluating LN status and guiding adjuvant therapy in endometrial cancer (EC). The standard surgical treatment of EC includes systematic LND, which is associated with morbidity. Consequently, there is debate weighing the risks and benefits of LND. Objectives: To evaluate the role of LND in all stages of EC. Search Strategy: Systematic search of MEDLINE up to 9th January 2020 including references of relevant studies. Selection Criteria: Published literature in English describing LND in EC. Data Collection and Analysis: 176 articles were screened by title and abstract to select those describing roles of LND in EC. Main Results: We confirmed the diagnostic role of LND and the benefits of risk stratifying early-stage EC patients, despite variations in stratification systems. Low and high-risk groups have well-established guidelines. The role of LND remains controversial in intermediate and high-intermediate risk groups. Sentinel lymph node dissection seems promising to prevent under-/overtreatment. In all risk groups, the prognostic role of LND is well-understood however therapeutic use is debatable. In most stages of advanced EC, LND is beneficial, except for non-bulky nodal disease. Variation exists in what constitutes adequate LN counts, targets and surgical methods. Conclusions: International standardisation of the definition of LND and further adoption of sentinel lymph node algorithms is required. Future research should investigate the need to stratify for bulky and non-bulky nodal disease in advanced EC. New RCTs are needed to guide revaluation of the ESMO-ESGO-ESTRO 2016 guidelines. Funding There were no costs associated with conducting or writing this review.

show abstract

Whether intermediate-risk stage 1A, grade 1/2, endometrioid endometrial cancer patients with lesions larger than 2 cm warrant lymph node dissection?

Cited by 14 publications

References 35 publications

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

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

Prognostic significance of lymphovascular space invasion in patients with endometrioid endometrial cancer: a retrospective study from a single center

The role of lymph node dissection in endometrial cancer: a systematic scoping review.

Contact Info

Product

Resources

About