title: Influence of quantity of lymph-vascular space invasion on the risk of nodal metastases in women with early-stage squamous cancer of the cervix.
abstract: OBJECTIVE
  To determine if the quantity of lymph-vascular space invasion influences the risk of pelvic nodal metastases in women with early-stage cervical squamous carcinoma.
  
  
  METHODS
  Between 1991 and 1997, 105 women with stages IA2, Ib, and IIa squamous carcinoma of the cervix underwent radical hysterectomy and pelvic lymphadenectomy. The histopathology slides were prospectively reviewed. If lymph-vascular space invasion (LVSI) was present, the amount was quantified in four ways: percentage of cervical histopathologic sections containing LVSI, percentage of sections with tumor containing LVSI, total number of foci of LVSI, and maximal number of foci of LVSI in 10 high-powered fields. These measures of LVSI were correlated with the risk of nodal metastases.
  
  
  RESULTS
  Seventy-three (70%) women had tumors with LVSI. Of these, 23 had pelvic nodal metastases. All women with nodal metastases had tumors with LVSI. Using logistic regession, independent predictors of nodal metastases were depth of cervical stromal invasion (P = 0.01) and tumor size (P = 0.04). LVSI was also a significant predictor of nodal metastases based on the Mantel-Haenszel test (P = 0.01). In women whose tumors contained LVSI, logistic regression identified tumor size (P = 0.004) and LVSI in > 45% of all cervical histopathologic sections (P = 0.002) as significant predictors of nodal metastases.
  
  
  CONCLUSIONS
  The quantity of LVSI, as defined by the percentage of all cervical histopathologic sections containing LVSI, correlates significantly with the risk of nodal metastases in women with early-stage squamous carcinoma of the cervix.
authors.affiliation: Department of Obstetrics and Gynecology, University of Southern California, Los Angeles 90033, USA.
authors.forename: L D
authors.initials: LD
authors.lastname: Roman
authors.forename: J C
authors.initials: JC
authors.lastname: Felix
authors.forename: L I
authors.initials: LI
authors.lastname: Muderspach
authors.forename: T
authors.initials: T
authors.lastname: Varkey
authors.forename: A F
authors.initials: AF
authors.lastname: Burnett
authors.forename: D
authors.initials: D
authors.lastname: Qian
authors.forename: C P
authors.initials: CP
authors.lastname: Morrow
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008208:Lymphatic System / Q000473:pathology*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000601:surgery