Lower uterine segment involvement as a predictor for lymph node spread in endometrial carcinoma

Does Lower Uterine Segment Involvement in Grade 3 Endometrial Cancer Impact Recurrence Patterns and Patient Outcomes?

“…Our study confirms that LUS involvement is associated with other poor prognostic factors including deep myometrial invasion (48.9% vs. 24.1%, P < 0.001), LVSI (52.9% vs. 30.5%, P < 0.001), and nodal metastases (38.7% vs. 11.6%, P < 0.001) similar to previously published studies [9,13,15]. In their analysis, which was limited to stage I and II tumors, Kizer et al found that 30% of LUS-positive cases had LVSI compared to only 16.3% in LUS-negative cases (P = 0.01).…”

“…However, they did not evaluate myometrial invasion or nodal status [15]. Madom et al found that LUS-positive cases had substantially more LVSI (39% vs. 4.3%, P < 0.01), positive nodes (25% vs. 8%, P < 0.01), and deep myometrial invasion (33.6% vs. 7.4%, P < 0.01) [9] and Lavie et al also reported more deep myometrial invasion in LUS-positive cases (34% vs. 14%, P = 0.003) [13]. LUS involvement has also been shown to be more frequently associated with type II histologies [12].…”

“…Stage, lymphovascular space invasion (LVSI), deep myometrial invasion, histologic subtypes and nodal involvement have been associated with increased recurrence risk and cancer-related mortality [6,7]. More recent investigation has suggested that LUS involvement may be associated with other poor prognostic features such as increased myometrial invasion, LVSI [8], nodal metastases [9], and higher-grade histology [10].…”

Identifiable Risk Factors for Lymph Node Metastases in Grade 1 Endometrial Carcinoma

“…26 Nevertheless, several studies have demonstrated that, in early endometrial carcinoma, the involvement of LUS is predictive of lymph node metastases and distant recurrence. 27,28 According to our results, the above stands also for grade 1 endometrial carcinomas and should probably be considered when assessing the risk groups to guide adjuvant treatment. Endometrial carcinomas present with various invasion patterns.…”

The Pattern of Myometrial Invasion as a Predictor of Lymph Node Metastasis or Extrauterine Disease in Low-grade Endometrial Carcinoma

“…Factors that have been traditionally used to predict advanced stage in cases of clinical stage I endometrioid adenocarcinoma include tumor grade and depth of myometrial invasion (4, 5). In recent years, other factors including tumor size (14), lower uterine segment involvement (16), cervical involvement (17), vascular/lymphatic invasion (17,18), revisions to the 3-tiered architectural grading system (19, 20) and the pattern of myometrial invasion (21, 22) have been proposed as potential predictive indicators of extrauterine disease. In this study, we assessed the relationship of the above mentioned predictive factors to the presence of advanced stage disease in a cohort of 304 cases of low grade (FIGO grades 1 and 2) endometrial endometrioid adenocarcinoma.…”