title: Preoperative lymph-vascular space invasion is associated with nodal metastases in women with early-stage cervical cancer.
abstract: OBJECTIVE
  To determine the association between findings on review of preoperative biopsy specimens and the risk of lymph node involvement (LNI) at radical hysterectomy in patients with early-stage cervical cancer.
  
  
  METHODS
  Eighty-one patients were included in this retrospective review. Preoperative biopsy features evaluated were stage, grade, histologic subtype, lymph-vascular space invasion (LVSI), and depth (>4 mm) of invasion.
  
  
  RESULTS
  Twelve patients (14.8%) had LNI at radical hysterectomy. Stage, grade, and histologic subtype were not associated with LNI. LVSI and depth of invasion >4 mm were both significantly associated with LNI (25.6% vs. 4.8%, P=0.01, and 25.0% vs. 4.5%, P=0.01, respectively). LVSI with >4 mm invasion was 6.6 times more likely to have LNI at the time of radical hysterectomy (RR=6.6; 95% confidence interval, 2.1-21.9).
  
  
  CONCLUSIONS
  Patients with preoperative LVSI are at higher risk for LNI at radical hysterectomy and should be counseled regarding potential implications for management.
authors.affiliation: Department of Gynecologic Oncology, The University of Texas, Unit 1362, M. D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Milam
authors.forename: Michael
authors.initials: M
authors.lastname: Frumovitz
authors.forename: Ricardo
authors.initials: R
authors.lastname: dos Reis
authors.forename: Russell R
authors.initials: RR
authors.lastname: Broaddus
authors.forename: Roland L
authors.initials: RL
authors.lastname: Bassett
authors.forename: Pedro T
authors.initials: PT
authors.lastname: Ramirez
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000601:surgery