title: Association between tumor diameter and lymphovascular space invasion among women with early-stage endometrial cancer.
abstract: OBJECTIVE
  To investigate the association between tumor diameter and intratumoral risk factors that might predict the need for full surgical staging among women with endometrial cancer (EC).
  
  
  METHODS
  Data from patients with early-stage EC treated at the Istituto Nazionale dei Tumori, Milan, Italy, between January 2004 and December 2012 were retrospectively analyzed. Associations between tumor diameter and tumor grade, myometrial invasion, risk group, lymphovascular space invasion (LVSI), and lower uterine segment (LUS) involvement were assessed by bivariate and multivariate analysis.
  
  
  RESULTS
  In total, 181 patients met the inclusion criteria. The tumor diameter was 2cm or less in 110 women (60%). χ(2) analysis showed that tumor grading, myometrial invasion, risk group, and LVSI were significantly associated with tumor size (P<0.001), whereas LUS involvement was marginally associated (P=0.051). By multivariate analysis, LVSI and myometrial invasion had an independent association with tumor size greater than 2cm (P<0.018).
  
  
  CONCLUSIONS
  Tumor size greater than 2cm was significantly and independently associated with LVSI and myometrial invasion among patients with early-stage EC. Given the difficulty of obtaining reliable LVSI data from frozen sections, tumor size might be used as a surrogate at the time of surgery to provide additional information to triage patients for full surgical staging.
authors: Gynecologic Oncology Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy; Department of Obstetrics and Gynecology, University of Uruguay School of Medicine, Montevideo, Uruguay. Electronic address: joellaufer@gmail.com.
authors: Joel
authors: J
authors: Laufer
authors: Santiago
authors: S
authors: Scasso
authors: Andrea
authors: A
authors: Papadia
authors: Claudio
authors: C
authors: Sosa
authors: Federico
authors: F
authors: Cirillo
authors: Francesco
authors: F
authors: Raspagliesi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016889:Endometrial Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D007558:Italy; D008207:Lymphatic Metastasis; D008875:Middle Aged; D015999:Multivariate Analysis; D009215:Myometrium / Q000473:pathology*; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D014594:Uterine Neoplasms / Q000473:pathology*
keywords: Endometrial cancer; Lymphovascular space invasion; Risk stratification; Tumor diameter