Preoperative lymph-vascular space invasion is associated with nodal metastases in women with early-stage cervical cancer.
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.
Milam
Michael R
MR
Department of Gynecologic Oncology, The University of Texas, Unit 1362, M. D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA.
Frumovitz
Michael
M
dos Reis
Ricardo
R
Broaddus
Russell R
RR
Bassett
Roland L
RL
Ramirez
Pedro T
PT
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