Prognostic value of lymphovascular space invasion in patients with early stage cervical cancer in Jilin, China

Yan, Wen; Qiu, Shuang; Ding, Yaming; Zhang, Qi; Si, Lihui; Lv, Sha; Liu, Linlin

doi:10.1097/md.0000000000017301

Cited by 22 publications

(21 citation statements)

References 30 publications

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“…However, the authors argue to take into account LVSI in this decision, as its presence is associated with LNMan association which has been demonstrated previously [9,11,12]. In a review by van Meurs et al on 535 patients with stage IA2 cervical cancer [9], tumours with LVSI were observed with a 12.0% LNM rate, versus 9.3% in our study.…”

Section: Discussionsupporting

confidence: 56%

Cervical cancer with ≤5 mm depth of invasion and >7 mm horizontal spread — Is lymph node assessment only required in patients with LVSI?

Wenzel

Kol

Nijman

et al. 2020

Gynecologic Oncology

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The necessity of pelvic lymph node assessment in microinvasive cervical cancer depends on LVSI and histological subtype • Lymph node assessment is essential in any tumour with LVSI • Lymph node assessment can be omitted in squamous cell carcinoma without LVSI • Lymph node assessment can be omitted in adenocarcinoma with b3 mm depth of invasion • Lymph node assessment can be omitted in tumours without LVSI and with b3 mm depth of invasion

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Section: Discussionsupporting

confidence: 56%

Cervical cancer with ≤5 mm depth of invasion and >7 mm horizontal spread — Is lymph node assessment only required in patients with LVSI?

Wenzel

Kol

Nijman

et al. 2020

Gynecologic Oncology

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“…Yan et al [ 29 ] also demonstrated an improved prognosis for the survival of IB1-IIB stage cervical cancer patients with high-risk factors or more than two intermediate-risk factors undergoing adjuvant CCRT therapy. However, patients with intermediate-risk factors do not benefit from a standardized treatment regimen, which requires therapy management under the experience of clinicians [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Prognostic Factors Associated with 5-Year Overall Survival in Cervical Cancer Patients Treated with Radical Hysterectomy Followed by Adjuvant Concurrent Chemoradiation Therapy at a Tertiary Care Center in Eastern Europe

Stanca

Căpîlna

2021

Diagnostics

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Background: This retrospective observational study aims to assess the 5-year overall survival and the prognostic significance of risk factors of patients who underwent radical hysterectomy followed by adjuvant concurrent chemoradiation therapy (CCRT) for FIGO stage IB1-IIB cervical cancer in a tertiary care center in Eastern Europe. Methods: From January 2010 to February 2019, 222 patients with stage IB1-IIB cervical cancer were treated with radical hysterectomy followed by adjuvant CCRT in our institution. The baseline information consisting of demographic and clinicopathologic data, treatment choices, recurrences, and outcome information was collected and examined. The survival rates were illustrated using Kaplan–Meier curves and prognosis analyses were accomplished using Cox multivariate analyses. Results: The 222 participants had a mean age of 51.2 years (28–76). The median follow-up time was 65.5 months (3–128). Tumor characteristics revealed FIGO stage (IB1 2.3%, IB2 35.1%, IB3 16.7%, IIA1 9%, IIA2 8.6%, IIB 28.4%) and the most encountered histologic cell type was squamous cell carcinoma (80.06%) followed by adenocarcinoma (11.3%). At the time of examination, 157 patients (70.07%) were alive, of which 135 (61%) were alive free of disease and 22 (9%) were alive with disease. The multivariate Cox regression analysis acknowledged stage IIB, parametrial involvement, and the presence of lymph node metastases as independent prognostic risk factors, significantly worsening the oncologic outcomes influencing the survival with a P-value of 0.076, 0.0001, and 0.008, respectively. The 5-year overall survival was 69.9%. Conclusions: Altogether, the study enhances the significance of prognostic risk factors on the 5-year overall survival of patients who underwent radical hysterectomy followed by adjuvant CCRT for FIGO stages IB1-IIB cervical cancer, allowing comparisons with other regions.

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“…Further, in our study, it would be more likely that LVSI is associated with a higher risk of lymph node metastases, regardless of LRH or ORH. There are studies 23–27 indicating that LVSI, together with other pathological characteristics such as tumor size, result in an increased risk of lymph node metastasis, that is one of the most important prognostic factors in cervical cancer.…”

Section: Discussionmentioning

confidence: 99%

Lymph-Vascular Space Invasion in Patients with Stages IA2-IIA2 Cervical Cancer Treated with Laparoscopic versus Open Radical Hysterectomy

Zhao¹,

Yang²

2021

CMAR

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Objective To explore the relationship between laparoscopic radical hysterectomy (LRH) and cervical cancer lymph-vascular space invasion (LVSI) by comparing the prevalence of LVSI in cervical cancer patients who underwent LRH versus open radical hysterectomy (ORH). Methods The study participants were 1087 cervical cancer patients (FIGO 2009 stages IA2-IIA2) with pathologically confirmed with or without LVSI who underwent radical hysterectomy at Shengjing Hospital of China Medical University from 2013 through 2018. The patients were divided according to the type of surgical procedure into an LRH group (n=148) and an ORH group (n=939). Results In the LRH group, 31.76% of patients (47/148) had LVSI-positive tumors compared to 33.23% of patients (312/939) in the ORH group; the difference was not significant (p=0.724). No between-group differences in LVSI prevalence according to lymph node metastasis, interstitial infiltration depth, differentiation degree, and parametrial infiltration were found. However, the number of LVSI-positive patients whose cervical cancer lesions >4 cm (stage I B2 and II A2) was significantly higher in the LRH group than in the ORH group (Odds Ratio [OR] 0.333, 95% confidence interval [CI] 0.157–0.706, p=0.005). The 3-Year disease-free survival (DFS) in the LRH group is lower than that in the ORH group (94.75% vs 97.27%), but there was no significance (P=0.187). Furthermore, the percentage of LVSI-positive tumors in patients with lymph node metastases was significantly higher than those without lymph node metastases (OR 2.897, 95% CI 2.129–3.942, p=0.000). The 3-Year DFS were 98.22% in the LVSI negative patients and 93.78% in the LVSI positive patients, the difference was significant (P=0.002). Conclusion A higher risk of lymph node metastasis and a lower 3-Year DFS was found in the LVSI-positive patients. In case of LVSI, it would be dangerous to treat patient in laparoscopy, especially in case of cervical cancer lesions >4cm.

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Prognostic value of lymphovascular space invasion in patients with early stage cervical cancer in Jilin, China

Abstract: Supplemental Digital Content is available in the text

Cited by 22 publications

References 30 publications

Cervical cancer with ≤5 mm depth of invasion and >7 mm horizontal spread — Is lymph node assessment only required in patients with LVSI?

Cervical cancer with ≤5 mm depth of invasion and >7 mm horizontal spread — Is lymph node assessment only required in patients with LVSI?

Prognostic Factors Associated with 5-Year Overall Survival in Cervical Cancer Patients Treated with Radical Hysterectomy Followed by Adjuvant Concurrent Chemoradiation Therapy at a Tertiary Care Center in Eastern Europe

Lymph-Vascular Space Invasion in Patients with Stages IA2-IIA2 Cervical Cancer Treated with Laparoscopic versus Open Radical Hysterectomy

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