title: Lymphovascular invasion is a significant predictor for distant recurrence in patients with early-stage endometrial endometrioid adenocarcinoma.
abstract: To evaluate the value of lymphovascular invasion (LVI) in endometrial endometrioid adenocarcinoma (EEA) as a predictor for distant recurrence, we analyzed the histopathologic features of 513 consecutive cases of nonsurgically staged EEA limited to the uterus. Grade, myoinvasion, cervical involvement, and LVI were evaluated. With a median follow-up of 28 months (range, 2-144 months), 67 cases (13.1%) recurred, 37 (7.2%) had locoregional recurrence, and 30 (5.8%) developed distant recurrence. LVI was identified in 116 cases (22.6%) cases and was the only adverse histopathologic finding in 23 cases; 5 (22%) of the 23 recurred. Multivariate analysis demonstrated a significant association between any type of recurrence and cervical involvement (hazard ratio [HR], 2.760; 95% confidence interval [CI], 1.621-4.698) and LVI (HR, 2.717; CI, 1.568-4.707). Multivariate analysis revealed LVI as the only independent predictor for distant recurrence (HR, 2.841; CI, 1.282-6.297). Studies to examine the role of adjuvant systemic therapy in patients with early-stage disease should be considered.
authors.affiliation: Department of Anatomic Pathology, Sunnybrook Health Sciences Center, Toronto, ON, Canada.
authors.forename: Sharon
authors.initials: S
authors.lastname: Nofech-Mozes
authors.forename: Ida
authors.initials: I
authors.lastname: Ackerman
authors.forename: Zeina
authors.initials: Z
authors.lastname: Ghorab
authors.forename: Nadia
authors.initials: N
authors.lastname: Ismiil
authors.forename: Gillian
authors.initials: G
authors.lastname: Thomas
authors.forename: Al
authors.initials: A
authors.lastname: Covens
authors.forename: Mahmoud A
authors.initials: MA
authors.lastname: Khalifa
mesh_terms: D018269:Carcinoma, Endometrioid / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D002584:Cervix Uteri / Q000473:pathology; D016889:Endometrial Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate