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Impact of depth and extent of lymphovascular space invasion on lymph node metastasis and recurrence patterns in endometrial cancer
Author(s) -
Matsuo Koji,
GarciaSayre Jocelyn,
Medeiros Fabiola,
Casabar Jennifer K.,
Machida Hiroko,
Moeini Aida,
Roman Lynda D.
Publication year - 2015
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.24049
Subject(s) - medicine , endometrial cancer , odds ratio , oncology , incidence (geometry) , metastasis , hysterectomy , lymph node , lymphovascular invasion , cancer , urology , radiology , physics , optics
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. J. Surg. Oncol. 2015;112:669–676 . © 2015 Wiley Periodicals, Inc.