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J Surg Oncol. 2015 Nov;112(6):669-76. doi: 10.1002/jso.24049. Epub 2015 Sep 22.

Impact of depth and extent of lymphovascular space invasion on lymph node metastasis and recurrence patterns in endometrial cancer.

Author information

1
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California.
2
Norris Comprehensive Cancer Center, University of Southern California, California.
3
Department of Pathology, University of Southern California, Los Angeles, California.

Abstract

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.

KEYWORDS:

chemotherapy; endometrial cancer; lymph node metastasis; lymphovascular space invasion; radiotherapy; recurrence

PMID:
26391212
DOI:
10.1002/jso.24049
[Indexed for MEDLINE]

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