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

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.

Relationship among Lymph Vascular Space Invasion with Clinicopathological Factors and Prognosis in Early Cervical Cancer / 实用妇产科杂志

Objective:To investigate the relationship among lymph vascular space invasion (LVSI) with clinicopathological factors and prognosis in early cervical cancer(CC).Methods:Retrospective analysis was conducted on 280 cases of early CC that were surgically treated at Dalian Maternal and Child Health Care hospital between January 2009 and June 2012.Univariate analysis was performed to study the relationship between LVSI and clinicopathological factors,the clinicopathological factors statistically associated with LVSI in univariate analysis were studied by multivariate analysis to identify the independent risk factors of LVSI.Results:①Univariate analysis showed that histological type,histological differentiation,lymph node metastasis and cervical stromal invasion depth were significantly correlated with LVSI (P ＜ O.05).Multivariate analysis showed that LVSI was an independent risk factor for differentiation,lymph node metastasis,and the depth of invasion.②The 5-year disease free survival(DFS) of LVSI positive patients was 74％,and the overall survival(OS) was 80％.The 5-year DFS and OS of LVSI negative patients were 93％ (P ＜ 0.05).Conclusions:LVSI can reflect the potential risk of lymph node metastasis to some extent.LVSI is the independent risk factor of lymph node metastasis and can significantly reduce the DFS and OS.Patients with LVSI positive may have deeper infiltration and poorer differentiation,but more studies are needed to confirm it.

The effect of lymph-vascular space invasion on clinicopathologic features in patients with endometrial cance / 대한산부인과학회지

OBJECTIVE: The aim of this study was to evaluate the effect of lymph-vascular space invasion (LVSI) on clinicopathologic features and outcomes in patients with endometrial cancer. METHODS: All women who were surgically treated for endometrial cancer at the Cheil General Hospital & Women's Healthcare Center between January 2000 and December 2003 were eligible. One hundred-forty one patients underwent retrospective review of medical record. Pathologic findings of LVSI were reviewed and divided in LVSI-positive group and LVSI-negative. Statistical analysis was performed by dBSTAT-4. RESULTS: Fifty-five patients (39%) were LVSI-positive and eighty-six patients (61%) were LVSI-negative. LVSI-positive patients were statistically older than LVSI-negative. LVSI-positive patients had more abnormal cytology, poorer differentiation, larger tumor size (diameter>2 cm), more myometrial invasion. more pelvic nodal metastasis, more paraaortic nodal metastasis, and more advanced stage. There was no difference between the two groups in the percentage of patients with gravidity, parity, histologic types (endometrioid vs nonendometrioid). CONCLUSION: LVSI-positive patients with endometrial cancer are generally older, consistent with more abnormal cytology, poorer differentiation, larger tumor size, more myometrial invasion, more lymph-node metastasis, and more advanced-stage disease. So, LVSI should be a consideration in appropriate treatment in endometrial cancer.