Lymph node metastasis and lymph vascular space invasion in microinvasive squamous cell carcinoma of the uterine cervix

Abstract

The objective of this study was to determine whether the depth of invasion was related to lymph vascular space invasion (LVSI) and lymph node metastasis and whether there was a correlation between LVSI and lymph node metastasis in stage IA cervical cancer. The medical records, including surgical notes and pathologic reports, of 202 patients with microinvasive squamous cell carcinoma of the uterine cervix were reviewed retrospectively. There was a positive correlation between the depth of invasion and the LVSI, and the incidence of lymph node metastasis was slightly higher than those reported hitherto for stage IA1 cervical cancer, especially in the depth of invasion of 1-3 mm group. However, among four patients with lymph node metastasis, only two patients had positive LVSI. There was no definite correlation between LVSI and lymph node metastasis. LVSI could not identify the patients with high risk for lymph node metastasis.

Lymphatic vessels around the uterus: D2-40 (podoplandin) immunohistochemistry using elderly cadavers

“…Micrometastasis along the uterine artery and superficial uterine vein has recently been considered a prognostic factor in patients with cervical and endometrial cancers [1,10,30].…”

The efficacy of long term follow-up and CO2 laser conization as conservative management in patients with cervical cancer stage FIGO IA1

“…After the conization and the diagnosis of Stage IA1 squamous cell cervical carcinoma, the patients were counselled about the possibility of a conservative management with careful post-treatment follow-up as an alternative to the conventional treatment proposed by guidelines [9].…”

“…Pelvic lymphadenectomy is considered taking into account the fact that the risk of lymph node metastases in cervical cancer with invasion less than 1 mm is insignificant in absence of lymphovascular space invasion (LVSI); the risk increases to 0.8% in case of stromal invasion between 1 and 3 mm and to 8.2% in presence of lympho-vascular space invasion [8][9][10][11].…”

Microinvasive Carcinoma of the Cervix

“…Lee and et al found that the lymphovascular space was compromised in 0.9% of cases when invasion was less than 1 mm and in 10.2 % when invasion was between 1 and 3 mm deep. 8 Ostor et al demonstrated compromise of the space lymphovascular in 3% and 15% when invasion was up to 1 mm and between 1 and 3 mm, respectively. 9 The requirements in relation to the involvement of the lymphovascular space with tumor cells are still points to ponder; therefore, understanding that doubt is part of the thought process, we propose the following reflections: (1) Why ignore the involvement of the lymphovascular space?…”

“…Thus, some studies demonstrate the following relation between depth of invasion and lymph node metastasis: invasion up to 1 mm, presence of <1 to 1.5% of lymph nodes compromised; between 1 and 3 mm, <1 to 4.2%; between 3 and 5 mm, between 2 and 3.7%. 8,9 Aimed at reducing the rate of complications of lymphadenectomy, the technique of sentinel lymph node biopsy (SLB), introduced by Cabañas, 15 has been studied in cases of cervical carcinoma. Studies evaluating the accuracy and applicability of sentinel lymph node biopsy in cervical carcinoma have shown promising results (high rates of detection and low falsepositive rates), mainly when analyzing cases of lesions less than 2 cm.…”