Lymphovascular space involvement in early stage well-differentiated endometrial cancer is associated with increased mortality.
OBJECTIVE
To study the relationship between lymphovascular space involvement (LVSI) in stage 1a or 1b well-differentiated endometrial cancer and survival.


METHODS
Retrospective study consisting of a search of an oncology database to identify women with endometrial cancer between January 1990 and December 2004.


METHODS
Tertiary referral centre, Dublin, Ireland.


METHODS
Women who had well-differentiated stage 1a or 1b endometrial cancer.


METHODS
During the period 1990-2004, 226 patients with endometrial cancer were treated in the National Maternity Hospital, Dublin. We looked at all patients who had well-differentiated endometrioid adenocarcinoma of the endometrium with invasion of <50% thickness of the myometrium. Forty-one patients fulfilled these inclusion criteria. The presence or absence of LSVI was determined by review of haematoxylin and eosin sections. Patients were followed for 5 years or till death if earlier. Mortality was calculated. Statistical analysis was performed using Fisher's exact test. An odds ratio and 95% confidence interval was calculated using fixed effect Mantel-Haenszel model.


METHODS
Death from recurrence of endometrial cancer.


RESULTS
Of the 41 patients, five (12%) were found to have (LVSI). Of the five patients with LVSI, three (60%) patients died of recurrence. All patients with recurrence died of disease and none of the patients without LVSI died (0 of 36). Overall, the survival rate was 92.7%. The presence of LVSI was a highly significant predictor of recurrence (P < 0.001).


CONCLUSIONS
In patients with early stage well-differentiated adenocarcinoma of the endometrium, the presence of LVSI is associated with a high risk of death.
O'Brien
D J
DJ
University College Dublin School of Medicine and Medical Science, National Maternity Hospital, Dublin, Ireland. donal.j.obrien@ucd.ie
Flannelly
G
G
Mooney
E E
EE
Foley
M
M
D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology*; D000328:Adult; D000368:Aged; D016889:Endometrial Neoplasms / Q000401:mortality* / Q000473:pathology*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D042601:Lymphatic Vessels / Q000473:pathology*; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000401:mortality*; D012189:Retrospective Studies