Journal of surgical oncology · 2015
Impact of depth and extent of lymphovascular space invasion on lymph node metastasis and recurrence patterns in endometrial cancer.
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Matsuo Koji, Garcia-Sayre Jocelyn, Medeiros Fabiola, Casabar Jennifer K, Machida Hiroko, Moeini Aida, Roman Lynda D
Аннотация
BACKGROUND AND OBJECTIVES: To determine the significance of depth and extent of lymphovascular space invasion (LVSI) on lymph node metastasis and recurrence in endometrial cancer.
METHODS: A case-control study was conducted to examine LVSI-positive (n = 70) and LVSI-negative (n = 641) stage I-III endometrial cancer cases that underwent hysterectomy-based surgical staging. The risk of lymph node metastasis and distant recurrence was estimated based on LVSI patterns.
RESULTS: In multivariate analysis, deep (>50% invasion), and extensive (≥7 foci/slide) LVSI patterns had a significantly increased risk of lymph node metastasis (incidence 57.6% and 72.7%, odds ratio 33.8 and 49.9, respectively, P < 0.001) as compared to other traditional uterine factors (>50% myometrial tumor invasion, cervical stromal invasion, and adnexal involvement: incidence range 30.4-37.9%, odds ratio range 3.80-7.03). Deep and extensive of LVSI patterns were both significantly correlated to distant recurrence (P < 0.001). Among women who received postoperative chemotherapy, deep and extensive LVSI patterns did not have increased risks for distant recurrence compared to no LVSI (P = 0.47 and 0.32, respectively). Among women who received postoperative radiotherapy, the depth of LVSI was significantly associated with recurrence outside the radiated field (P = 0.02).
CONCLUSIONS: Depth and extent of LVSI are important predictors for lymph node metastasis and distant recurrence in endometrial cancer.
METHODS: A case-control study was conducted to examine LVSI-positive (n = 70) and LVSI-negative (n = 641) stage I-III endometrial cancer cases that underwent hysterectomy-based surgical staging. The risk of lymph node metastasis and distant recurrence was estimated based on LVSI patterns.
RESULTS: In multivariate analysis, deep (>50% invasion), and extensive (≥7 foci/slide) LVSI patterns had a significantly increased risk of lymph node metastasis (incidence 57.6% and 72.7%, odds ratio 33.8 and 49.9, respectively, P < 0.001) as compared to other traditional uterine factors (>50% myometrial tumor invasion, cervical stromal invasion, and adnexal involvement: incidence range 30.4-37.9%, odds ratio range 3.80-7.03). Deep and extensive of LVSI patterns were both significantly correlated to distant recurrence (P < 0.001). Among women who received postoperative chemotherapy, deep and extensive LVSI patterns did not have increased risks for distant recurrence compared to no LVSI (P = 0.47 and 0.32, respectively). Among women who received postoperative radiotherapy, the depth of LVSI was significantly associated with recurrence outside the radiated field (P = 0.02).
CONCLUSIONS: Depth and extent of LVSI are important predictors for lymph node metastasis and distant recurrence in endometrial cancer.
Предметные рубрики MeSH
Adenocarcinoma, Clear CellCase-Control StudiesCombined Modality TherapyCystadenocarcinoma, SerousEndometrial NeoplasmsFemaleFollow-Up StudiesHumansLymphatic MetastasisMiddle AgedMyometriumNeoplasm GradingNeoplasm InvasivenessNeoplasm Recurrence, LocalNeoplasm StagingPrognosisStromal CellsSurvival RateUterine Cervical Neoplasms