Lymphovascular space invasion in endometrial carcinoma: Tumor size and location matter

Oliver-Pérez, Reyes; Magrina, Javier F.; Villalaín, Cecilia; Jiménez‐López, Jesús; González, Gregorio López; Bárcena, Carmen; Martinez-Biosques, Concepcion; Gil-Ibáñez, Blanca; Tejerizo-García, A.

doi:10.1016/j.suronc.2021.101541

Cited by 14 publications

(8 citation statements)

References 31 publications

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“…Our study showed that in addition to tumor size, grade II (p < 0.01) and stage IB (p < 0.01) tumors were also significantly associated with lymph node metastasis. More recently, in 2021, Oliver-Perez et al also studied different factors that could be correlated with lymphovascular space invasion and concluded that in type I endometrial carcinoma, involvement of the lower uterine segment and tumor size of >2 cm were independent risk factors for lymphovascular space invasion [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Assessing Tumor Size by MRI and Pathology in Type I Endometrial Carcinoma to Predict Lymph Node Metastasis

Ali¹,

Mumtaz²,

Naqvi³

et al. 2022

Cureus

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IntroductionLymphatic spread is the most common route of spread of endometrial carcinoma, and the most frequently involved lymph nodes are those of the external iliac group. MRI is one of the best imaging tools for the preoperative evaluation of patients with endometrial carcinoma. The objective of the current study is to analyze the relationship between tumor size and lymph node metastasis in patients with type I endometrial carcinoma.

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Section: Discussionmentioning

confidence: 99%

Assessing Tumor Size by MRI and Pathology in Type I Endometrial Carcinoma to Predict Lymph Node Metastasis

Ali¹,

Mumtaz²,

Naqvi³

et al. 2022

Cureus

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“…30 From the perspective of pathology, LVI represents occult tumor cells that enter the bloodstream for systemic circulation and therefore have potential risks to survival. 25,31 This finding suggested that the LVI was able to determine the extent of tumor invasion and predict the course of OS better than the pT or pN stage alone.…”

Section: Discussionmentioning

confidence: 95%

“…Because the incidence of LVI is correlated with the depth of tumor infiltration, MRI has multiple advantages in determining tumor invasion depth, thus indirectly prompting the LVI state 30 . From the perspective of pathology, LVI represents occult tumor cells that enter the bloodstream for systemic circulation and therefore have potential risks to survival 25,31 . This finding suggested that the LVI was able to determine the extent of tumor invasion and predict the course of OS better than the pT or pN stage alone.…”

Section: Discussionmentioning

confidence: 99%

Risk Stratification and Overall Survival Prediction in Advanced Gastric Cancer Patients Based on Whole‐Volume MRI Radiomics

Chen

Gao

et al. 2023

Magnetic Resonance Imaging

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BackgroundThe prognosis of advanced gastric cancer (AGC) patients has attracted much attention, but there is a lack of evaluation method. MRI‐based radiomics has the potential to evaluate AGC patients' prognosis.PurposeTo identify and validate the risk stratification and overall survival (OS) in AGC patients using MRI‐based radiomics.Study TypeRetrospective.SubjectsA total of 233 patients (168 males, 63.6 ± 11.1 years; 65 females, 59.7 ± 11.8 years) confirmed AGC were collected. The data were randomly divided into a training (164) and validation set (69).SequenceA 3.0 T, axial T2‐weighted, diffusion‐weighted imaging, and contrast‐enhanced T1‐weighted (CE‐T1WI).AssessmentRadiologist 1 segmented 233 patients and radiologist 2 segmented randomly 50 patients on CE‐T1WI. The risk score (RS) was summed by each sample based on the radiomics features and correlation coefficients. Patients were followed up for 7–67 months (median 41; 138 dead and 95 alive).Statistical TestsThe intraclass correlation coefficient (ICC) and Kappa value were calculated. Differences in survival analysis were assessed by Kaplan–Meier curves and log‐rank test. Cox‐regression analysis was performed to identify the radiomics features and clinical indicators associated with OS. The calibration curves were built to assess the model. A two‐tailed P value < 0.05 was considered statistically significant.ResultsIntegrated with age, lymphovascular invasion (LVI) and RS, a survival combined model was built. The area under the curve (AUC) for predicting 3‐year and 5‐year OS was 0.765 and 0.788 in the training set, 0.757 and 0.729 in the validation set. There was no significant difference between the radiomics model and survival combined model for 3‐year (0.690 vs. 0.757, P = 0.425) and 5‐year OS (0.687 vs. 729, P = 0.412) in the validation set. The calibration curves showed a high degree of fit for the survival combined model.Data ConclusionThis study established a survival combined model that might help AGC patients in future clinical decision‐making.Evidence Level33Technical EfficacyStage 5

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“…Myometrial invasion is a much earlier molecular event and could be the initial driving force for the further progression of cancer cells. LVSI has been postulated as one of the first steps in the metastatic spread of EC and is accepted as a prerequisite for lymphatic dissemination 26 . The likelihood of pelvic LNM increases dramatically with deeper myometrial invasion and LVSI, a clear reflection of increasing exposure to lymphatics as a tumor grows along and through the uterine wall 27 , 28 .…”

Section: Discussionmentioning

confidence: 99%

Patterns of lymph node metastases and their implications in individualized radiotherapeutic clinical target volume delineation of regional lymph nodes in patients with endometrial cancer

Teng¹,

Yu²,

Wang³

et al. 2022

J. Cancer

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Purpose: To study the patterns of lymph node metastasis (LNM) of endometrial cancer (EC) and to clarify the individualized clinical target volume delineations of regional lymph nodes (CTVn). Methods: Data from a total of 556 patients with EC who had undergone total hysterectomy associated with bilateral salpingo-oophorectomy (TH/BSO) and systematic lymphadenectomy were retrospectively examined. The clinicopathological factors related to LNM were analyzed using logistic regression analysis. Results: LNM was found in 76 of 556 patients, resulting in a metastasis rate of 13.67%. The rates of LNM in patients with fundus and cornua lesions were 7.56% for para-aortic nodes and 14.41% for pelvic lymph nodes. The rates of LNM in patients with sidewall lesions were 3.15% for para-aortic nodes and 10.22% for pelvic lymph nodes. The rates of LNM in patients with lower uterine segment and cervix lesions were 12.50% for para-aortic nodes and 26.67% for pelvic lymph nodes. Deep myometrial invasion, histological type, histological differentiation, and lymphovascular space invasion (LVSI) emerged as statistically significant risk factors for pelvic LNM of EC (P = 0.008, 0.015, < 0.001, 0.005, respectively). Grade 3 differentiation had a strong influence on LNM to the para-aortic nodes (P = 0.015). Conclusions: Myometrial invasion, histological type, histological differentiation, and LVSI were related to pelvic LNM and grade 3 was associated with para-aortic LNM. These factors should be considered comprehensively to design the CTVn for intensity-modulated radiation therapy (IMRT) of EC. For patients with lower uterine segment/cervix and fundus/cornua lesions, delineating the irradiation field of the para-aortic nodal region may confer a benefit.

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Lymphovascular space invasion in endometrial carcinoma: Tumor size and location matter

Cited by 14 publications

References 31 publications

Assessing Tumor Size by MRI and Pathology in Type I Endometrial Carcinoma to Predict Lymph Node Metastasis

Assessing Tumor Size by MRI and Pathology in Type I Endometrial Carcinoma to Predict Lymph Node Metastasis

Risk Stratification and Overall Survival Prediction in Advanced Gastric Cancer Patients Based on Whole‐Volume MRI Radiomics

Patterns of lymph node metastases and their implications in individualized radiotherapeutic clinical target volume delineation of regional lymph nodes in patients with endometrial cancer

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