Evaluation of Clinical Significance of Lymphovascular Space Invasion in Stage IA Endometrial Cancer

Okugawa, Kaoru; Yahata, Hideaki; Hachisuga, Kazuhisa; Tomonobe, Hiroshi; Yasutake, Nobuko; Kodama, Kazuhisa; Kenjo, Hironori; Yagi, Hiroshi; Ohgami, Tatsuhiro; Yasunaga, Masafumi; Onoyama, Ichiro; Asanoma, Kazuo; Hori, Emiko; Ohishi, Yoshihiro; Oda, Yoshinao; Kato, Kiyoko

doi:10.1159/000521382

Cited by 3 publications

(7 citation statements)

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“…After removing duplicates, 463 articles underwent title and abstract screening, and 41 articles were selected for full-text screening. Ultimately, 15 studies ( 3 , 6 – 14 , 19 – 23 ) involving 6705 patients were included in the data analysis. The characteristics of the 15 included studies are shown in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Nine studies ( 3 , 6 – 9 , 11 , 12 , 14 , 21 ) involving 3,337 patients evaluated the relationship between LVSI and recurrence. The recurrence rate for patients with LVSI was 18.10% (72/398), compared to 6.16% (181/2939) for patients without LVSI in stage I EC.…”

Section: Resultsmentioning

confidence: 99%

“…Five studies ( 8 – 10 , 14 , 20 ) reported on the OS of 2,880 patients. LVSI-positive patients in stage I EC had a 5.19-fold higher risk of death than LVSI-negative patients (95%CI 3.33-8.07; I 2 = 0, p = 0.739; Figure 3A ).…”

Section: Resultsmentioning

confidence: 99%

“…LVSI has been reported as a risk factor, even in cases of stage I EC without lymph node metastasis ( 9 – 11 ). Conversely, several studies have concluded that LVSI does not significantly affect survival rates in patients with early-stage EC ( 12 – 14 ). For instance, Okugawa et al.…”

Section: Introductionmentioning

confidence: 97%

“…For instance, Okugawa et al. ( 14 ) reported that the 5-year EC specific survival rates for tumors in LVSI-positive and LVSI-negative patients were 97.0% and 98.9%, which do not show significant difference. Furthermore, there is a lack of consensus on whether adjuvant therapy is necessary for stage I EC patients with LVSI after surgery.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of prognostic significance of lymphovascular space invasion in early stage endometrial cancer: a systematic review and meta-analysis

Qin,

Wang,

Chen

et al. 2024

Front. Oncol.

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BackgroundStudies evaluating the prognostic significance of lymphovascular space invasion (LVSI) in early stage endometrial cancer (EC) are conflicting.ObjectivesTo evaluate whether LVSI identified in stage I EC is associated with worse survival.Search strategyA comprehensive literature search of three databases (Embase, PubMed, and Cochrane) was performed up to April 30th 2023.Selection criteriaCohort studies that have evaluated the relationship between LVSI and prognosis in patients with stage I EC were included.Data collection and analysisTwo authors independently assessed the studies for inclusion, extracted the data of recurrence and survival, and conducted meta-analysis using random effects model. Heterogeneity was evaluated by I2 test.Main resultsA total of 15 studies involving 6,705 patients were included in the meta-analysis. The overall pooled rate of LVSI was 14% [95% confidence interval (CI) CI 0.09-0.18] in stage I EC. LVSI was significantly associated with a higher risk of recurrence [odds ratio (OR) = 2.79, 95%CI 2.07-3.77], reduced overall survival (OS) [hazard ratio (HR)=5.19, 95%CI 3.33-8.07] and recurrence free survival (RFS) [HR = 5.26, 95%CI 3.45-8.02] in stage I EC patients. Similarly, LVSI was associated with an increased risk of recurrence [OR= 3.10, 95%CI 2.13-4.51], decreased OS [HR=5.52, 95%CI 2.16-14.09] and RFS [HR = 4.81, 95%CI 2.34-9.91] in stage IA grade 1 or 2 endometrioid carcinoma patients.ConclusionThe presence of LVSI in stage I EC and in stage IA, grade 1 or 2 endometrioid carcinoma is associated with an increased risk of recurrence, lower OS and RFS.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier 42023425231.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Evaluation of prognostic significance of lymphovascular space invasion in early stage endometrial cancer: a systematic review and meta-analysis

Qin,

Wang,

Chen

et al. 2024

Front. Oncol.

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New online dynamic nomograms to predict recurrence-free and overall survival after resection of endometrial cancer: a single-institution retrospective cohort study

Hu,

Li,

2024

Arch Gynecol Obstet

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Purpose The significant global burden of endometrial cancer (EC) and the challenges associated with predicting EC recurrence indicate the need for a dynamic prediction model. This study aimed to propose nomograms based on clinicopathological variables to predict recurrence-free survival (RFS) and overall survival (OS) after surgical resection for EC. Methods This single-institution retrospective cohort study included patients who underwent surgical resection for EC. Web-based nomograms were developed to predict RFS and OS following resection for EC, and their discriminative and calibration abilities were assessed. Results This study included 289 patients (median age, 56 years). At a median follow-up of 51.1 (range, 4.1–128.3) months, 13.5% (39/289) of patients showed relapse or died, and 10.7% (31/289) had non-endometrioid tumors (median size: 2.8 cm). Positive peritoneal cytology result (hazard ratio [HR], 35.06; 95% confidence interval [CI], 1.12–1095.64; P = 0.0428), age-adjusted Charlson comorbidity index (AACCI) (HR, 52.08; 95% CI, 12.35–219.61; P < 0.001), and FIGO (Federation of Gynecology and Obstetrics) stage IV (HR, 138.33; 95% CI, 17.38–1101.05; P < 0.001) were predictors of RFS. Similarly, depth of myometrial invasion ≥ 1/2 (HR, 1; 95% CI, 0.46–2.19; P = 0.995), AACCI (HR, 93.63; 95% CI, 14.87–589.44; P < 0.001), and FIGO stage IV (HR, 608.26; 95% CI, 73.41–5039.66; P < 0.001) were predictors of OS. The nomograms showed good predictive capability, positive discriminative ability, and calibration (RFS: 0.895 and OS: 0.891). Conclusion The nomograms performed well in internal validation when patients were stratified into prognostic groups, offering a personalized approach for risk stratification and treatment decision-making.

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New online dynamic nomograms: recurrence-free and overall survival after resection of endometrial cancer

2023

Preprint

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Background This study aimed to propose nomograms based on clinicopathological variables to predict recurrence-free survival (RFS) and overall survival (OS) in patients after surgical resection therapy for endometrial cancer (EC).Methods Patients who underwent surgical therapy for EC were identified in this single-institution retrospective cohort study from January 1, 2012, to August 31, 2022. Web-based nomograms were developed to predict RFS and OS following EC resection. C-statistics, calibration plots, and Kaplan-Meier curves were used to assess the discriminative and calibration abilities of the nomograms.Results This study included 289 patients who underwent surgery for EC. At a median follow-up of 51.1 (range, 4.1-128.3) months, 13.5% (39 of 289) of the patients showed a relapse or died from their disease. The median age of the participants was 56 years. Approximately one-tenth of the patients (10.7% [31/289]) had non-endometrioid tumor with a median size of 2.8 cm. RFS was predicted using the Akaike data criteria and a backward stepwise selection of clinically relevant variables: positive peritoneal cytology (PC; hazard ratio [HR], 35.58; 95% confidence interval [CI], 3.43-369.39; P = 0.0028), age-adjusted Charlson comorbidity index (AACCI) (HR, 25.51; 95% CI, 8.74–74.49; P < 0.001), FIGO stage III (HR, 3.01; 95% CI, 1.25–7.22; P = 0.0136), FIGO stage IV (HR, 82.92; 95% CI, 22.27-308.76; P < 0.001). Similarly, OS was predicted using depth of myometrial invasion ≥ 1/2 (HR, 1.18; 95% CI, 0.57–2.46; P = 0.6551), AACCI (HR, 20.09; 95% CI, 6.82–59.16; P < 0.001), FIGO stage III (HR, 3.23; 95% CI, 1.35–7.72; P = 0.0083), FIGO stage IV (HR, 81.56; 95% CI, 20.49-324.57; P < 0.001). Using C-statistics, the nomograms showed good predictive capability and positive discriminative ability and calibration (RFS: 0.895 and OS: 0.891).Conclusions Independent factors were chosen to predict survival and recurrence risk following surgical therapy for EC. The nomograms performed well in the internal validation when patients were stratified into prognostic groups.

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Evaluation of Clinical Significance of Lymphovascular Space Invasion in Stage IA Endometrial Cancer

Cited by 3 publications

References 16 publications

Evaluation of prognostic significance of lymphovascular space invasion in early stage endometrial cancer: a systematic review and meta-analysis

Evaluation of prognostic significance of lymphovascular space invasion in early stage endometrial cancer: a systematic review and meta-analysis

New online dynamic nomograms to predict recurrence-free and overall survival after resection of endometrial cancer: a single-institution retrospective cohort study

New online dynamic nomograms: recurrence-free and overall survival after resection of endometrial cancer

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