Vascular invasion in uterine sarcomas and its significance. A multi-institutional study

Roma, Andres A.; Barbuto, Denise; Samimi, Siavash Azadmanesh; Stolnicu, Simona; Alvarado‐Cabrero, Isabel; Chanona-Vilchis, José; Aguilera-Barrantes, Irene; Peralta‐Venturina, Mariza de; Malpica, Anaís; Rutgers, Joanne L.; Silva, Elvio G.

doi:10.1016/j.humpath.2015.07.011

Cited by 9 publications

(5 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…LVI has been shown to be an adverse pathologic finding associated with decreased survival in several solid malignancies, including uterine carcinosarcomas. [6][7][8]15 For STS, several studies from Scandinavia have been published examining the prognostic value of vascular invasion, specifically, although none review the broader finding of LVI. In 1994, Gustafson published a series of 508 patients with STS and found that vascular invasion was a strong and independent predictor of survival.…”

Section: Discussionmentioning

confidence: 99%

The Prognostic Value of Lymphovascular Invasion in Truncal and Extremity Soft Tissue Sarcomas: An Analysis from the National Cancer Database

et al. 2019

View full text Add to dashboard Cite

Objective.-The aim of this study was to determine the association between lymphovascular invasion (LVI) and overall survival (OS) in truncal/extremity soft tissue sarcomas (STS). Methods.-The National Cancer Database (NCDB) was queried for all patients, ages 18-85 years, who underwent resection of primary, truncal/extremity STS between 2010 and 2012, and had LVI data. The primary endpoint was OS. Results.-Among 6169 patients identified, the most common histology groups were (1) liposarcoma (LPS, 24%), (2) undifferentiated pleiomorphic sarcoma (UPS, 19%), and (3) leiomyosarcoma (LMS, 15%); 449 patients (7%) were LVI-positive. There were no differences in demographics or comorbidities between the LVI groups. Compared with LVI-negative patients, LVI-positive patients were more likely to have larger (> 5 cm: 80% vs. 66%), deep (80% vs. 68%), and high-grade tumors (82% vs. 57%). They were also more likely to have positive margins (27% vs. 17%), nodal (16% vs. 2%) and metastatic disease (21% vs. 4%), and receive chemotherapy (37% vs. 18%; all p < 0.001). LVI was associated with worse median OS (39 months vs. MNR; p < 0.001), which persisted on stratum-specific analyses for all tumor grades, size categories, and stages I-III, but not stage IV. On multivariable Cox regression, LVI was associated with worse OS (hazard ratio [HR] 1.84, 95% confidence interval [CI] 1.39-2.44), while accounting for other significant prognostic factors. Among non-metastatic, curative-intent resections (n = 5696), LVI was still associated with worse OS (HR 1.79, 95% CI 1.28-2.49). Conclusions.-LVI appears to be an important adverse pathologic factor in truncal and extremity STS. Even when taking into account other established prognostic factors, LVI was predictive of worse OS. Knowledge of LVI status may help to better risk-stratify patients and

show abstract

Section: Discussionmentioning

confidence: 99%

The Prognostic Value of Lymphovascular Invasion in Truncal and Extremity Soft Tissue Sarcomas: An Analysis from the National Cancer Database

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Finally, the staining for ERG, a remarkably specific endothelial marker, holds promise due to its high specificity for LVI [53,54]. A study by Kim et al analyzed fifteen cases of surgically resected CRC tumors with hepatic metastasis, representative of LVI, and subjected them to ERG, CD31, and D2-40 staining.…”

Section: Erg Immunohistochemical Stainingmentioning

confidence: 99%

The Usefulness of Elastin Staining to Detect Vascular Invasion in Cancer

Gonzalez,

Bahmad,

Ocejo

et al. 2023

IJMS

View full text Add to dashboard Cite

Tumor prognosis hinges on accurate cancer staging, a pivotal process influenced by the identification of lymphovascular invasion (LVI), i.e., blood vessel and lymphatic vessel invasion. Protocols by the College of American Pathologists (CAP) and the World Health Organization (WHO) have been established to assess LVI in various tumor types, including, but not limited to, breast cancer, colorectal cancer (CRC), pancreatic exocrine tumors, and thyroid carcinomas. The CAP refers to blood vessel invasion as “angioinvasion” (vascular invasion) to differentiate it from lymphatic vessel invasion (lymphatic invasion). For clarity, the latter terms will be used throughout this review. The presence of lymphatic and/or vascular invasion has emerged as a pivotal prognostic factor; therefore, its accurate identification is crucial not only for staging but also for providing the patient with an honest understanding of his/her prognosis. Given the prognostic importance of the correct identification of LVI, specific staining techniques are employed to distinguish lymphatic vessel invasion from angioinvasion and to differentiate true LVI from artifact. These encompass hematoxylin and eosin (H&E) staining, elastic staining, Factor VIII staining, Ulex europaeus I agglutinin staining, CD31, CD34, D2-40, ERG, and D2-40 (podoplanin) immunohistochemical (IHC) stains among others. Based on a review of numerous publications regarding the efficacy of various methods for LVI detection, elastin staining demonstrated superior accuracy and prognostic value, allowing for more targeted treatment strategies. The clinical significance of accurately detecting LVI cannot be overstated, as it is strongly linked to higher cancer-related mortality and an increased risk of tumor recurrence. This review aims to examine the existing literature on the use of elastin stains in the detection of vascular invasion among different types of tumors and its prognostic value.

show abstract

“…One study evaluated specific patterns of vascular involvement by low-grade endometrial stromal sarcoma, high-grade endometrial stromal sarcoma, leiomyosarcoma, and undifferentiated uterine sarcoma and divided patterns into "true" vascular invasion versus "intrusion" into lymphovascular spaces (125). True LVI was characterized by dyscohesive clusters of tumors cells with irregular edges, lacking vasculature within the intravascular tumor and/or lack of immunohistochemically proven endothelial cells surrounding the intravascular tumor focus.…”

Section: LVImentioning

confidence: 99%

“…Vascular intrusion, which was considered to be "pseudoinvasion," was characterized by cohesive intravascular tumor with smooth contours and lined by endothelial cells. Pre-existing vascular spaces were frequently identified within the intravascular tumor in the cases of vascular intrusion and such foci were often in direct communication with the main tumor mass (125).…”

Section: LVImentioning

confidence: 99%

Data Set for Reporting of Uterine Malignant and Potentially Malignant Mesenchymal Tumors: Recommendations From the International Collaboration on Cancer Reporting (ICCR)

Nucci

Webster

Croce

et al. 2022

International Journal of Gynecological Pathology

View full text Add to dashboard Cite

The International Collaboration on Cancer Reporting (ICCR) seeks to produce standardized, evidence-based protocols for the reporting of tumors with the aim of ensuring that all cancer reports generated worldwide will be of similar high quality and record the same elements. Herein, we describe the development of the data set for the reporting of uterine malignant and potentially malignant mesenchymal tumors by a panel of expert pathologists and a single clinician and provide the commentary and rationale for the inclusion of core and noncore elements. This data set, which incorporates the recent updates from the 5th edition of the World Health Organization Classification of Female Genital Tumors, addresses several subjects of debate including which mesenchymal tumors should be graded, how to document extent of invasion, mitotic counts, and the role of ancillary testing in tumor diagnosis and patient management. The inclusion of elements is evidence-based or based on consensus of the expert panel with clinical relevance being the guiding standard.

show abstract

Vascular invasion in uterine sarcomas and its significance. A multi-institutional study

Cited by 9 publications

References 26 publications

The Prognostic Value of Lymphovascular Invasion in Truncal and Extremity Soft Tissue Sarcomas: An Analysis from the National Cancer Database

The Prognostic Value of Lymphovascular Invasion in Truncal and Extremity Soft Tissue Sarcomas: An Analysis from the National Cancer Database

The Usefulness of Elastin Staining to Detect Vascular Invasion in Cancer

Data Set for Reporting of Uterine Malignant and Potentially Malignant Mesenchymal Tumors: Recommendations From the International Collaboration on Cancer Reporting (ICCR)

Contact Info

Product

Resources

About