The Impact of Lymphovascular Space Invasion on Recurrence and Survival in Iranian Patients With Early Stage Endometrial Cancer

Akhavan, Setareh; Ahmadzadeh, Ali; Mousavi, Azam Sadat; Gilany, Mitra Modares; Kazemi, Zohreh; Rahim, Fakher; Shirali, Elham

doi:10.14740/wjon981w

Cited by 4 publications

(3 citation statements)

References 39 publications

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“…The presence of lymph-vascular space invasion (LVSI) in endometrial cancer has been demonstrated to be significantly and independently associated with poor outcome. LVSI has been associated with decreased survival [1234567] and increased risk of disseminated disease at time of diagnosis [8], including pelvic and paraaortic lymph node (LN) metastasis [79101112]. Moreover, the risk of recurrence also seems to be increased in these patients [2456813].…”

Section: Introductionmentioning

confidence: 99%

Lymph-vascular space invasion (LVSI) as a strong and independent predictor for non-locoregional recurrences in endometrial cancer: a Danish Gynecological Cancer Group Study

et al. 2019

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Objective To evaluate the effect of lymph-vascular space invasion (LVSI) on location of recurrences in Danish patients with endometrial cancer. Methods This national cohort study (2005–2012) included 4,380 radically operated patients (no visual tumor, all distant metastasis removed). LVSI status was recorded in 3,377 (77.1%). In stage I patients, 2.6% received adjuvant radiotherapy and 1.4% adjuvant chemotherapy. Adjusted Cox regression was used to compare actuarial recurrence rates. Results LVSI was present in 18.7% of 3,377 patients with known LVSI status. Of these, 7.6% stage I patients with LVSI experienced an isolated locoregional and 19.4% a non-locoregional recurrence. Compared to no LVSI, 5-year recurrence rate was higher (25.5% vs. 8.5%) in patients with LVSI and the frequency of distant recurrences was strikingly higher (stage I: 15.2% vs. 2.7%), the effect being similar across International Federation of Gynecology and Obstetrics stages and histological types. In intermediate-risk stage I patients with LVSI, 8.0% experienced an isolated locoregional recurrence compared to 20.1% with non-locoregional recurrence, giving these patients a seriously adverse risk of survival. A separate analysis in patients with recurrences demonstrated that those with LVSI had significantly more distant recurrences (55.4% vs. 29.9%) and fewer isolated vaginal recurrences (24.3% vs. 42.8%) than patients with no LVSI. Conclusion LVSI is a strong independent risk factor for the development of non-locoregional recurrences even in intermediate-risk stage I endometrial cancer. The non-locoregional recurrence pattern suggests a future focus for optimization of postoperative treatment in these patients.

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Section: Introductionmentioning

confidence: 99%

Lymph-vascular space invasion (LVSI) as a strong and independent predictor for non-locoregional recurrences in endometrial cancer: a Danish Gynecological Cancer Group Study

et al. 2019

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“…A study conducted in early-stage endometrial cancer patients found that LVSI significantly and independently influenced the three-year and five-year survival rates [12]. Another study echoed these findings, emphasizing that patients with lower International Federation of Obstetrics and Gynecology (FIGO) stages but with confirmed LVSI presence may be at an increased risk of recurrence and poor overall survival [13].…”

Section: Discussionmentioning

confidence: 98%

Endometrial Carcinoma: A Comprehensive Analysis of Clinical Parameters, Treatment Modalities, and Prognostic Outcomes at a Tertiary Oncology Center in the UAE

Balaraj,

Shanbhag,

Bin Sumaida

et al. 2023

Cureus

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BackgroundEndometrial carcinoma (EC) remains a pressing global health issue, with a discernible upsurge in incidence, especially in developed countries. Notably, the United Arab Emirates (UAE) has witnessed a surge in EC cases, demanding an in-depth, region-specific exploration into the disease's clinical, treatment, and prognostic facets against the backdrop of its unique socio-genetic and environmental contours. AimThis study aimed to profess a comprehensive understanding of EC by examining clinical parameters, treatment modalities, and prognostic outcomes in the UAE context, thereby seeking to delineate potential correlations between varied therapeutic combinations, patient demographics, and tumor characteristics in affecting prognostic outcomes. Materials and methodsA retrospective cohort study involving 93 patients diagnosed with EC from January 2011 to March 2023 at a leading oncology center in the UAE was conducted. Data, including demographic information, clinical presentation, treatment modalities, and prognostic outcomes, were meticulously extracted and analyzed. The R software (version 4.2.2) facilitated exhaustive statistical analyses, involving descriptive statistics, correlation analyses with the polycor package, and survival analyses utilizing the Kaplan-Meier method and Cox regression analysis via the survival and survminer packages, respectively. ResultsAlthough the correlation matrix revealed a noticeable relationship between "Family history" and "Age," most parameters displayed independence, offering a robust platform for ensuing multivariate analyses. Kaplan-Meier survival curves, stratified by therapeutic modalities, exhibited no statistically significant survival differences across therapeutic cohorts (p-values: 0.44, 0.86, and 0.83). Conversely, the composite Cox regression model underscored "non-national" demographic, Diabetes Mellitus II, and stromal invasion as pivotal prognostic factors, indicating the multifactorial nature of survival in EC patients and emphasizing demographic and tumor characteristics over therapeutic modalities as influential prognostic determinants. ConclusionIn conclusion, while therapy types were not directly correlated with survival, demographic and tumor traits prominently impacted prognostic outcomes, advocating for an intricate, multidimensional approach to managing EC in the UAE. This study hopes to sow seeds for subsequent research, shaping clinically and culturally apt practices and policies in the region's healthcare landscape.

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“…Thus, it is important to determine the presence of LVSI preoperatively for the decision-making whether to perform lymphadenectomy ( 5 ). Furthermore, adjuvant treatment is recommended in early-stage EC patients with LVSI (high intermediate risk) ( 6 , 7 ).…”

Section: Introductionmentioning

confidence: 99%

Radiomics feature as a preoperative predictive of lymphovascular invasion in early-stage endometrial cancer: A multicenter study

et al. 2022

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BackgroundThe presence of lymphovascular space invasion (LVSI) has been demonstrated to be significantly associated with poor outcome in endometrial cancer (EC). No effective clinical tools could be used for the prediction of LVSI preoperatively in early-stage EC. A radiomics nomogram based on MRI was established to predict LVSI in patients with early-stage EC.MethodsThis retrospective study included 339 consecutive patients with early-stage EC with or without LVSI from five centers. According to the ratio of 2:1, 226 and 113 patients were randomly assigned to a training group and a test group, respectively. Radiomics features were extracted from T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), contrast-enhanced (CE), diffusion-weighted imaging (DWI), and apparent diffusion coefficient (ADC) maps. The radiomics signatures were constructed by using the Least Absolute Shrinkage and Selection Operator (LASSO) algorithm in the training group. The radiomics nomogram was developed using multivariable logistic regression analysis by incorporating radiomics signatures and clinical risk factors. The sensitivity, specificity, and AUC of the radiomics signatures, clinical risk factors, and radiomics nomogram were also calculated.ResultsThe individualized prediction nomogram was constructed by incorporating the radiomics signatures with the clinical risk factors (age and cancer antigen 125). The radiomics nomogram exhibited a good performance in discriminating between negative and positive LVSI patients with AUC of 0.89 (95% CI: 0.83–0.95) in the training group and of 0.85 (95% CI: 0.75–0.94) in the test group. The decision curve analysis indicated that clinicians could be benefit from the using of radiomics nomogram to predict the presence of LVSI preoperatively.ConclusionThe radiomics nomogram could individually predict LVSI in early-stage EC patients. The nomogram could be conveniently used to facilitate the treatment decision for clinicians.

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The Impact of Lymphovascular Space Invasion on Recurrence and Survival in Iranian Patients With Early Stage Endometrial Cancer

Cited by 4 publications

References 39 publications

Lymph-vascular space invasion (LVSI) as a strong and independent predictor for non-locoregional recurrences in endometrial cancer: a Danish Gynecological Cancer Group Study

Lymph-vascular space invasion (LVSI) as a strong and independent predictor for non-locoregional recurrences in endometrial cancer: a Danish Gynecological Cancer Group Study

Endometrial Carcinoma: A Comprehensive Analysis of Clinical Parameters, Treatment Modalities, and Prognostic Outcomes at a Tertiary Oncology Center in the UAE

Radiomics feature as a preoperative predictive of lymphovascular invasion in early-stage endometrial cancer: A multicenter study

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