The prognostic significance of lymph-vascular space invasion in stage I endometrial cancer

Hanson, M.; Nagell, J.R. van; Powell, Deborah E.; Donaldson, Elvis S.; Gallion, Holly H.; Merhige, Michael E.; Pavlik, Edward J.

doi:10.1002/1097-0142(19850415)55:8<1753::aid-cncr2820550823>3.0.co;2-p

Cited by 143 publications

(49 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This seems to be due to the undifferentiated component of the histology. The median number of removed pelvic LNs was 16 (range, [15][16][17][18][19][20][21][22][23][24][25][26][27], the median number of removed para-aortic LNs was 8 (range, 4-30), and the median number of positive paraaortic LNs was 1 (range, 1-4). All patients had FIGO stage IIIC2 disease.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Lymph-Vascular Space Invasion as a Significant Risk Factor for Isolated Para-aortic Lymph Node Metastasis in Endometrial Cancer: A Study of 203 Consecutive Patients

et al. 2010

View full text Add to dashboard Cite

Background. The purpose of this study was to investigate various pathologic risk factors associated with para-aortic lymph node metastasis (LNM) in surgically staged patients with endometrial cancer. Materials and Methods. We performed a retrospective analysis of 203 consecutive patients with endometrial cancer who were surgically staged from 2000 to 2009. The association among the various pathologic variables for para-aortic LNM was determined with univariate and multivariate analyses. Results. Of 203 patients, 29 patients (14.3%) had LNM. Also, 10 patients (4.9%) had only pelvic LNM, 14 (6.9%) had both pelvic and para-aortic LNM, and 5 (2.5%) had para-aortic LNM without pelvic LN involvements. Histologic type (P = .001), tumor grade (P \ .001), tumor size (P = .003), depth of myometrial invasion (P \ .001), cervical invasion (P \ .001), parametrial invasion (P = .002), lymph-vascular space invasion (LVSI) (P \ .001), serosal/ adnexal invasion (P \ .001), positive cytology (P = .002), peritoneal seeding (P \ .001), and pelvic LNM (P \ .001) were significant pathologic factors for para-aortic LNM. On multivariate analysis, cervical invasion (P = .032), LVSI (P = .018), and positive pelvic LNs (P = .002) were independent factors for para-aortic LNM. With regard to isolated para-aortic LNM, tumor grade (P = .017) and LVSI (P = .002) were significant factors for LN involvements. On multivariate analysis, LVSI (P = .004) was the only significant independent factor. Conclusions. LVSI correlates significantly with the risk of isolated para-aortic LNM in endometrial cancer patients.Lymph node metastasis (LNM) is one of the important prognostic factors in endometrial cancer. The Gynecologic Oncology Group (GOG) published two large surgicalpathological studies of women with clinical stage I or II endometrial cancer.1,2 A substantial number of patients with clinical stage I disease (22%) had extrauterine disease, and tumor grade, depth of myometrial invasion, cervical invasion, vascular space invasion, positive cytology, adnexal involvement, and certain histologic types were found to be risk factors for pelvic and para-aortic LNM. Based on these results, the International Federation of Gynecology and Obstetrics (FIGO) adopted a surgical staging system to replace the clinical staging system in 1988.3 FIGO stage IIIC disease meant pelvic or para-aortic LN involvement. Several studies demonstrated that stage IIIC disease had diversity in the prognosis and patients with para-aortic LNM had poorer survival than those with negative paraaortic LNs.2,4-8 Recently, the FIGO revised the surgical staging system. 9 Stage IIIC disease was divided into two categories of IIIC1 with positive pelvic LNs and IIIC2 with positive para-aortic LNs, irrespective of the status of pelvic LNs status.Para-aortic LNM occurs mainly by way of pelvic LNM.4,10 However, direct spread to para-aortic LNs via ovarian vessels is a possible route of lymphatic spread, and patients have isolated para-aortic LNM without positive pelvic LNs. [10][11][12] ...

show abstract

Section: Resultsmentioning

confidence: 99%

“…19 Tumor cells first develop the capacity for local tissue invasion and then spread through gaps between endothelial cells into the lymph-vascular space of the stroma, and, once LVSI has occurred, tumor cells have the potential for metastatic spread to other sites. 20 LVSI may lead to tumor emboli invading pelvic and para-aortic LNs.…”

Section: Discussionmentioning

confidence: 99%

Lymph-Vascular Space Invasion as a Significant Risk Factor for Isolated Para-aortic Lymph Node Metastasis in Endometrial Cancer: A Study of 203 Consecutive Patients

et al. 2010

View full text Add to dashboard Cite

show abstract

“…The incidence of LVSI in patients with endometrial cancer is reported to be about 25% when all the stages and tumor grades are included [11,14]. In previous studies, the incidence of LVSI in clinical stage I was 14%-16% [8,9,15] and it was 15.5%-32.6% in clinical stages I and II [3,16]. The incidence of LVSI was 4.3% in surgical stages I and II [17] and it was 24.6% to 34.4% when all the surgical stages were included [18,19].…”

Section: Discussionmentioning

confidence: 98%

“…Once LVSI has occurred, the tumor cells theoretically have the potential to metastasize to regional lymph nodes or further. Thus, LVSI has been noted as an important prognostic factor that is signifi cantly correlated with nodal metastases, tumor recurrence, and patient survival [1,2,8]. The fi ndings of previous studies have been contradictory with respect to the significance of LVSI as an independent prognostic factor.…”

mentioning

confidence: 99%

The prognostic significance of lymphovascular space involvement in patients with uterine-confined endometrioid endometrial cancer

Lim

Lee

Park

2012

Korean J Obstet Gynecol

View full text Add to dashboard Cite

“…Extrauterine factors include adnexal involvement, intraperitoneal metastasis, positive peritoneal cytology (13,14) and pelvic and para-aortic lymph node metastasis (7,15). Patients with no evidence of extrauterine disease, no cervical involvement and no evidence of vascular invasion are at low overall risk of recurrence.…”

Section: Introductionmentioning

confidence: 99%

Assessment of tumor size as a useful marker for the surgical staging of endometrial cancer

et al. 2014

View full text Add to dashboard Cite

Abstract. Accumulating evidence suggests that the estimation of tumor size may improve endometrial cancer treatment. We conducted an observational study aimed at elucidating the association between tumor size and other universally accepted prognostic factors in order to identify suitable preoperative parameters which can guide surgery in a subgroup of early corpus endometrial cancer. We found that when tumor size increased, both stage and grading were significantly increased. Tumor size was correlated with CA 125 serum values, node metastasis and peritoneal cytology status. Patients who have grade 1 or 2 endometrioid corpus cancer, myometrial invasion <50% and ≤3 cm largest tumor diameter can only be treated with hysterectomy. The tumor largest diameter should be evaluated as a preoperative parameter that indicates patients who do not require lymphadenectomy.

show abstract

The prognostic significance of lymph-vascular space invasion in stage I endometrial cancer

Cited by 143 publications

References 11 publications

Lymph-Vascular Space Invasion as a Significant Risk Factor for Isolated Para-aortic Lymph Node Metastasis in Endometrial Cancer: A Study of 203 Consecutive Patients

Lymph-Vascular Space Invasion as a Significant Risk Factor for Isolated Para-aortic Lymph Node Metastasis in Endometrial Cancer: A Study of 203 Consecutive Patients

The prognostic significance of lymphovascular space involvement in patients with uterine-confined endometrioid endometrial cancer

Assessment of tumor size as a useful marker for the surgical staging of endometrial cancer

Contact Info

Product

Resources

About