Lymph node metastasis and pattern of recurrence in clinically early stage endometrial cancer with positive lymphovascular space invasion.
10.3802/jgo.2015.26.3.208
- Author:
Haider MAHDI
1
;
Amelia JERNIGAN
;
Benjamin NUTTER
;
Chad MICHENER
;
Peter G ROSE
Author Information
1. Division of Gynecologic Oncology, Ob/Gyn & Women's Health Institute, Cleveland, OH, USA. mahdih6281@gmail.com
- Publication Type:Original Article
- Keywords:
Survival;
Endometrial Neoplasms;
Recurrence;
Lymph Nodes;
Lymphovascular Space Invasion;
Retrospective Studies
- MeSH:
Aged;
Chemoradiotherapy, Adjuvant;
Disease-Free Survival;
Endometrial Neoplasms/mortality/*pathology/therapy;
Female;
Humans;
Lymph Node Excision/mortality;
Lymphatic Metastasis;
Middle Aged;
Neoplasm Invasiveness;
Neoplasm Recurrence, Local/mortality/*pathology/therapy;
Retrospective Studies;
Treatment Outcome
- From:Journal of Gynecologic Oncology
2015;26(3):208-213
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To investigate the rate, predictors of lymph node metastasis (LNM) and pattern of recurrence in clinically early stage endometrial cancer (EC) with positive lymphovascular space invasion (LVSI). METHODS: Women with clinically early stage EC and positive LVSI 2005 to 2012 were identified. Kaplan-Meier curves and logistic regression models were used. RESULTS: One hundred forty-eight women were identified. Of them, 25.7% had LNM (21.7% pelvic LNM, 18.5% para-aortic LNM). Among patients with LNM who had both pelvic and para-aortic lymphadenectomy, isolated pelvic, para-aortic and both LNM were noted in 51.4%, 17.1%, and 31.4% respectively. Age and depth of myometrial invasion were significant predictors of LNM in LVSI positive EC. Node positive patients had high recurrence rate (47% vs. 11.8%, p<0.05) especially distant (60.9% vs. 7.9%, p<0.001) and para-aortic (13.2% vs. 1.8%, p=0.017) recurrences compared to node negative EC. LNM was associated with lower progression-free survival (p=0.002) but not overall survival (p=0.73). CONCLUSION: EC with positive LVSI is associated with high risk of LNM. LNM is associated with high recurrence rate especially distant and para-aortic recurrences. Adjuvant treatments should target prevention of recurrences in these areas.
