Premium
The grading of lymphovascular space invasion in endometrial carcinoma
Author(s) -
Hachisuga Toru,
Kaku Tsunehisa,
Fukuda Kouichi,
Eguchi Fuyuki,
Emoto Makoto,
Kamura Toshiharu,
Iwasaka Tsuyoshi,
Kawarabayashi Tatsuhiko,
Sugimori Hajime,
Mori Mitsuru
Publication year - 1999
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19991115)86:10<2090::aid-cncr29>3.0.co;2-7
Subject(s) - medicine , grading (engineering) , lymphovascular invasion , carcinoma , endometrial cancer , oncology , pathology , metastasis , cancer , biology , ecology
BACKGROUND This study was conducted to elucidate the prognostic significance of a three‐grade system for lymphovascular space invasion (LVSI). METHODS The prognostic significance of the grading of LVSI as compared with other pathologic variables was evaluated in a study of 303 Japanese women with endometrial carcinoma. The criteria for determining the grade of LVSI were as follows: none (no LVSI), mild (a focus of LVSI was recognized around a tumor), and severe (diffuse or multifocal LVSI were recognized around the tumor or in the myometrium regardless of the degree of myometrial invasion). Both univariate and multivariate regression analyses were performed. The effects of different surgical methods and adjuvant therapies on survival were also examined. RESULTS A univariate survival analysis showed that survival significantly correlated with surgical stage, histologic grade, depth of myometrial invasion, LVSI, cervical invasion, ovarian metastasis, and tubal metastasis. Of the three grades of LVSI, survival showed the most difference between the mild and severe groups. In multivariate analysis, the highest correlation with survival was observed for LVSI ( P = 0.0008). Lymph node metastasis was also significantly associated with LVSI ( P = 0.0001). The correlation between histologic variables and survival was only slightly influenced by the differences in surgical methods and adjuvant therapies. CONCLUSIONS The grading of LVSI was found to be an important histologic prognostic variable. The severe degree of LVSI also was found to be a good indicator of lymph node metastasis. It is therefore important to evaluate the grade of LVSI based on a histologic examination of at least one cut surface of the hysterectomy specimen that macroscopically shows the deepest myometrial invasion. Cancer 1999;86:2090–7. © 1999 American Cancer Society.