Lower uterine segment involvement in lymphovascular space invasion and lymph node metastasis in endometrioid endometrial cancer

Çökmez, Hakan; Yılmaz, Alpay

doi:10.5603/gp.2019.0057

Cited by 6 publications

(11 citation statements)

References 32 publications

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“…11 There are conflicting results regarding the importance of LUS involvement in traditionally staged EC. 16,18,20 Although ULSI seems to be associated with worse survival outcomes, the main reason for increasing LN involvement in cases with ULSI is the possibility of high LVSI rates. 16,20,21 In the literature, ULSI rates in EC cases have been reported in a wide range of 3%-42%.…”

Section: Discussionmentioning

confidence: 99%

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Effect of low uterine segment involvement on prognosis of early stage endometrial cancer

Akdöner,

Kurt,

Yavuz

et al. 2024

J of Obstet and Gynaecol

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AimOur aim is to investigate the effect of uterine lower segment involvement on prognosis of early‐stage endometrial cancer cases diagnosed and treated in our clinic.Materials and MethodsThe file records of 316 cases reviewed retrospectively.Only stage I (a and b, n=209) cases were investigated, because they were more homogeneous group.ResultsThe lymphovascular invasion rate was found to be higher in patients with stage Ia and uterine lower segment involvement (p < 0.001). Adjuvant treatment requirement was higher in patients with stage Ia and uterine lower segment involvement (p < 0.001). Among stage Ia cases, the recurrence rate between 1 and 3 years was found to be higher in cases with uterine lower segment involvement (p = 0.001). Among the stage Ib cases, lymphovascular invasion was found to be higher in cases with uterine lower segment involvement (p < 0.001). The recurrence rate between 1 and 3 years was found to be higher in stage Ib compared to Ia (p = 0.01). Uterine lower segment involvement was found to be associated with high lymphovascular invasion rate in all stage I cases (p < 0.001). It was determined that the need for adjuvant treatment was higher in cases with uterine lower segment involvement (p < 0.001). It was determined that the probability of recurrence between 1 and 3 years was higher in cases with uterine lower segment involvement (p = 0.007).ConclusionUterine lower segment involvement is associated with increased lymphovascular invasion even in the early stages. It is an important risk factor for systemic spread such as lymphovascular invasion, myometrial invasion, and lymph node involvement.

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Section: Discussionmentioning

confidence: 99%

“…[12][13][14][15] There are few studies in the literature with conflicting results examining the effect of ULSI on endometrial cancer prognosis. [16][17][18][19] Our aim in this study is to investigate the effect of ULSI on prognosis in early-stage (stage I) EC cases diagnosed and treated in our clinic.…”

Section: Introductionmentioning

confidence: 99%

Effect of low uterine segment involvement on prognosis of early stage endometrial cancer

Akdöner,

Kurt,

Yavuz

et al. 2024

J of Obstet and Gynaecol

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“…Involvement of the cervix or lower uterine segment in endometrial carcinoma is associated with adverse prognostic factors, such as myometrial infiltration, serous surface of the uterus involvement, lymph node metastasis, and higher histological grade [ 38 ]. Cokmez et al found that lower uterine involvement and lymphovascular space invasion were significantly correlated with lymph node metastasis [ 39 ]. Kizer et al also showed that lower uterine segment involvement was associated with a high risk of recurrence and death in patients with early EC [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

A nomogram prediction model for the TP53mut subtype in endometrial cancer based on preoperative noninvasive parameters

Wang

Gao

et al. 2023

BMC Cancer

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Background The molecular subtypes of endometrial carcinoma are significantly correlated with survival outcomes and can guide surgical methods and postoperative adjuvant therapy. Among them, the TP53mut subtype has the worst prognosis and can only be determined by detection after surgery. Therefore, identifying preoperative noninvasive clinical parameters for early prediction of the TP53mut subtype would provide important guidance in choosing the appropriate surgical method and early warning for clinicians. Our study aimed to establish a model for the early prediction of the TP53mut subtype by using preoperative noninvasive parameters of endometrial cancer and screen out potential TP53mut patients. Methods Information and pathological specimens of 376 patients who underwent surgery for FIGO stage I-IV endometrial cancer in the Department of Gynecology, Peking University Cancer Hospital, from June 2011 to July 2020 were collected, and 178 cases were finally included in the study as the training dataset (part A). Thirty-six cases from January 2022 to March 2023 were collected as the validation dataset (part B). Molecular subtyping was performed using a one-stop next-generation sequencing (NGS) approach. Compared with the TP53mut subtype, the POLE EDM, MSI-H and TP53 wild-type subtypes were defined as non-TP53mut subtypes. Univariate Cox regression analysis and multivariate logistic analysis were performed to determine the preoperative clinical parameters associated with the TP53mut subtype. A nomogram prediction model was established using preoperative noninvasive parameters, and its efficacy in predicting TP53mut subtype and survival outcomes was verified. Results The TP53mut subtype was identified in 12.4% of the part A and 13.9% of the part B. Multivariate logistic regression analysis showed that HDL-C/LDL-C level, CA125 level, and cervical or lower uterine involvement were independent influencing factors associated with the TP53mut subtype (p = 0.016, 0.047, <0.001). A TP53mut prognostic model (TPMM) was constructed based on the factors identified in the multivariate analysis, namely, TPMM = -1.385 × HDL-C/LDL-C + 1.068 × CA125 + 1.89 × CI or LUI, with an AUC = 0.768 (95% CI, 0.642 to 0.893) in the part A. The AUC of TPMM for predicting TP53mut subtype in the part B was 0.781(95% CI, 0.581 to 0.980). The progression-free survival (PFS) and overall survival (OS) of patients with the TP53mut subtype were significantly worse than those of patients with the non-TP53mut subtype, as predicted by the model in the part A. Conclusions TP53mut prediction model (TPMM) had good diagnostic accuracy, and survival analysis showed the model can identify patients with different prognostic risk.

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“…Cokmez and Yilmaz reported LUSI in 49 (19.4%) of 253 cases of endometrioid endometrial carcinoma [32]. Patients with LUSI presented more LVSI (36.7% vs. 11.8%, p < 0.05) and more lymph node metastasis (18.4% vs. 4.9%, p < 0.05) than patients without LUSI [32]. Pathologists should report LUSI because this information could be used as a staging criterion for endometrial carcinoma in the future.…”

Section: Plos Onementioning

confidence: 98%

“…Lower uterine segment involvement (LUSI) correlates with more LVSI and other poor prognostic factors, such as lymph node metastasis, uterine serosal involvement, and deep myometrial invasion [31]. Cokmez and Yilmaz reported LUSI in 49 (19.4%) of 253 cases of endometrioid endometrial carcinoma [32]. Patients with LUSI presented more LVSI (36.7% vs. 11.8%, p < 0.05) and more lymph node metastasis (18.4% vs. 4.9%, p < 0.05) than patients without LUSI [32].…”

Section: Plos Onementioning

confidence: 99%

Ten years of experience with endometrial cancer treatment in a single Brazilian institution: Patient characteristics and outcomes

et al. 2020

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Few reports have described the clinical and prognostic characteristics of endometrial cancer, which is increasing worldwide, in large patient series in Brazil. Our objective was to analyze the clinicopathological characteristics, prognostic factors, and outcomes of patients with endometrial cancer treated and followed at a tertiary Brazilian institution over a 10-year period.This retrospective study included 703 patients diagnosed with endometrial cancer who were treated at a public academic tertiary hospital between 2008 and 2018. The following parameters were analyzed: age at diagnosis, race, body mass index, serum CA125 level before treatment; histological type and grade, and surgical stage. Outcomes were reported relative to histological type, surgical staging, serum CA125, lymph-vascular space involvement (LVSI), and lymph-node metastasis. The median patient age at diagnosis was 63 (range, 27-93) years (6.4% were <50 years). Minimally invasive surgeries were performed in 523 patients (74.4%). Regarding histological grade, 468 patients (66.5%) had low-grade endometrioid histology and 449 patients (63.9%) had stage I tumors. Tumors exceeded 2.0 cm in 601 patients (85.5%). Lymphadenectomy was performed in 551 cases (78.4%). LVSI was present in 208 of the patients' tumors (29.5%). Ninety-three patients (13.2%) had recurrent tumors and 97 (13.7%) died from their malignant disease. The robust prognostic value of FIGO stage and

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Lower uterine segment involvement in lymphovascular space invasion and lymph node metastasis in endometrioid endometrial cancer

Cited by 6 publications

References 32 publications

Effect of low uterine segment involvement on prognosis of early stage endometrial cancer

Effect of low uterine segment involvement on prognosis of early stage endometrial cancer

A nomogram prediction model for the TP53mut subtype in endometrial cancer based on preoperative noninvasive parameters

Ten years of experience with endometrial cancer treatment in a single Brazilian institution: Patient characteristics and outcomes

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