Lymphovascular space invasion as a predictive factor for lymph node metastases and survival in endometrioid endometrial cancer – a Swedish Gynecologic Cancer Group (SweGCG) study

Stålberg, Karin; Bjurberg, Maria; Borgfeldt, Christer; Carlson, Joseph W.; Dahm‐Kähler, Pernilla; Flöter-Rådestad, Angelique; Hellman, Kristina; Hjerpe, Elisabet; Holmberg, Erik; Kjølhede, Preben; Marcickiewicz, Janusz; Rosenberg, Per; Tholander, Bengt; Åvall‐Lundqvist, Elisabeth; Högberg, Thomas

doi:10.1080/0284186x.2019.1643036

Cited by 78 publications

(51 citation statements)

References 24 publications

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“…There have been no studies on lymphovascular invasion of rectal cancer using radiomics. Lymphovascular invasion has been studied in breast (28); colorectal (29); and endometrial cancers (30); and urinary tract urothelial carcinoma (31). However, radiomics was only used in the lymphovascular invasion of breast cancer (32).…”

Section: Discussionmentioning

confidence: 99%

A Novel Multimodal Radiomics Model for Preoperative Prediction of Lymphovascular Invasion in Rectal Cancer

Zhang

Guo

et al. 2020

Front. Oncol.

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Objective: To explore a new predictive model of lymphatic vascular infiltration (LVI) in rectal cancer based on magnetic resonance (MR) and computed tomography (CT). Methods: A retrospective study was conducted on 94 patients with histologically confirmed rectal cancer, they were randomly divided into training cohort (n = 65) and validation cohort (n = 29). All patients underwent MR and CT examination within 2 weeks before treatment. On each slice of the tumor, we delineated the volume of interest on T2-weighted imaging, diffusion weighted imaging, and enhanced CT images, respectively. A total of 1,188 radiological features were extracted from each patient. Then, we used the student t-test or Mann-Whitney U-test, Spearman's rank correlation and least absolute shrinkage and selection operator (LASSO) algorithm to select the strongest features to establish a single and multimodal logic model for predicting LVI. Receiver operating characteristic (ROC) curves and calibration curves were plotted to determine how well they explored LVI prediction performance in the training and validation cohorts. Results: An optimal multi-mode radiology nomogram for LVI estimation was established, which had significant predictive power in training (AUC, 0.884; 95% CI, 0.803-0.964) and validation (AUC, 0.876; 95% CI, 0.721-1.000). Calibration curve and decision curve analysis showed that the multimodal radiomics model provides greater clinical benefits. Conclusion: Multimodal (MR/CT) radiomics models can serve as an effective visual prognostic tool for predicting LVI in rectal cancer. It demonstrated great potential of preoperative prediction to improve treatment decisions.

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Section: Discussionmentioning

confidence: 99%

A Novel Multimodal Radiomics Model for Preoperative Prediction of Lymphovascular Invasion in Rectal Cancer

Zhang

Guo

et al. 2020

Front. Oncol.

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“…The prognosis is worse for women with presence of deep (≥50%) myometrial invasion (MI), lympho-vascular invasion, cervical stromal invasion, International Federation of Gynecology and Obstetrics (FIGO) grade 3 (poorly differentiated) tumor or nonendometrioid histology. These women also have a higher risk for lymph node metastases (3)(4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

“…These women also have a higher risk for lymph node metastases. [3][4][5][6] For women with endometrioid grade 1 or grade 2 tumors where deep MI is absent the probability of metastases in the pelvic lymph nodes is low and lymphadenectomy is considered unnecessary, avoiding complications such as lymphedema/lymph cyst formation. 7,8 Preoperative triaging is therefore important to select high-risk women for lymphadenectomy and avoid overtreatment of others.…”

Section: Introductionmentioning

confidence: 99%

Preoperative and intraoperative assessment of myometrial invasion in endometrial cancer—A Swedish Gynecologic Cancer Group (SweGCG) study

Jónsdóttir

Marcickiewicz

Borgfeldt

et al. 2021

Acta Obstet Gynecol Scand

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Introduction: Deep myometrial invasion (≥50%) is a prognostic factor for lymph node metastases and decreased survival in endometrial cancer. There is no consensus regarding which pre/intraoperative diagnostic method should be preferred. Our aim was to explore the pattern of diagnostic methods for myometrial invasion assessment in Sweden and to evaluate differences among magnetic resonance imaging (MRI), transvaginal sonography, frozen section, and gross examination in clinical practice. Material and methods:This is a nationwide historical cohort study; women with endometrial cancer with data on assessment of myometrial invasion and FIGO stage I-III registered in the Swedish Quality Registry for Gynecologic Cancer (SQRGC) between 2017 and 2019 were eligible. Data on age, histology, FIGO stage, method and results of myometrial invasion assessment, pathology results, and hospital level were collected from the SQRGC. The final assessment by the pathologist was considered gold standard.Results: In the study population of 1401 women, 32% (n=448) had a myometrial invasion ≥50%.The methods reported for myometrial invasion assessment were transvaginal sonography in 59%, MRI in 28%, gross examination in 8% and frozen section in 5% of cases. Only minor differences were found for age and FIGO stage when comparing methods applied for myometrial invasion assessment. The sensitivity, specificity, and accuracy to find myometrial invasion ≥50% with transvaginal sonography was 65.6%, 80.3% and 75.8%, for MRI 76.9%, 71.9% and 73.8%, for gross examination 71.9%, 93.6% and 87.3% while for frozen section it was 90.0%, 92.7% and 92.0% respectively. Conclusions:In Sweden, the assessment of deep myometrial invasion is most often performed with transvaginal sonography, but the sensitivity is lower than for the other diagnostic methods. In clinical practice, the accuracy is moderate for transvaginal sonography and MRI.

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“…Our group previously reported LVSI as an independent risk factor for lymph node metastases and decreased survival in patients with endometrioid adenocarcinomas [ 24 ]. In this material we also included the non-endometrioid carcinomas where, in the multivariable analyses, we found LVSI to be an independent prognostic factor for decreased overall survival in endometrial cancer stage I-III.…”

Section: Discussionmentioning

confidence: 99%

Survival in endometrial cancer in relation to minimally invasive surgery or open surgery – a Swedish Gynecologic Cancer Group (SweGCG) study

et al. 2021

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Background The aim of this study was to analyze overall survival in endometrial cancer patients’ FIGO stages I-III in relation to surgical approach; minimally invasive (MIS) or open surgery (laparotomy). Methods A population-based retrospective study of 7275 endometrial cancer patients included in the Swedish Quality Registry for Gynecologic Cancer diagnosed from 2010 to 2018. Cox proportional hazard models were used in univariable and multivariable survival analyses. Results In univariable analysis open surgery was associated with worse overall survival compared with MIS hazard ratio, HR, 1.39 (95% CI 1.18–1.63) while in the multivariable analysis, surgical approach (MIS vs open surgery) was not associated with overall survival after adjustment for known risk factors (HR 1.12, 95% CI 0.95–1.32). Higher FIGO stage, non-endometrioid histology, non-diploid tumors, lymphovascular space invasion and increasing age were independent risk factors for overall survival. Conclusion The minimal invasive or open surgical approach did not show any impact on survival for patients with endometrial cancer stages I-III when known prognostic risk factors were included in the multivariable analyses.

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Lymphovascular space invasion as a predictive factor for lymph node metastases and survival in endometrioid endometrial cancer – a Swedish Gynecologic Cancer Group (SweGCG) study

Cited by 78 publications

References 24 publications

A Novel Multimodal Radiomics Model for Preoperative Prediction of Lymphovascular Invasion in Rectal Cancer

A Novel Multimodal Radiomics Model for Preoperative Prediction of Lymphovascular Invasion in Rectal Cancer

Preoperative and intraoperative assessment of myometrial invasion in endometrial cancer—A Swedish Gynecologic Cancer Group (SweGCG) study

Survival in endometrial cancer in relation to minimally invasive surgery or open surgery – a Swedish Gynecologic Cancer Group (SweGCG) study

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