title: Impact of depth and extent of lymphovascular space invasion on lymph node metastasis and recurrence patterns in endometrial cancer.
abstract: OBJECTIVE
  To determine the significance of depth and extent of lymphovascular space invasion (LVSI) on lymph node metastasis and recurrence in endometrial cancer.
  
  
  METHODS
  A case-control study was conducted to examine LVSI-positive (n = 70) and LVSI-negative (n = 641) stage I-III endometrial cancer cases that underwent hysterectomy-based surgical staging. The risk of lymph node metastasis and distant recurrence was estimated based on LVSI patterns.
  
  
  RESULTS
  In multivariate analysis, deep (>50% invasion), and extensive (≥7 foci/slide) LVSI patterns had a significantly increased risk of lymph node metastasis (incidence 57.6% and 72.7%, odds ratio 33.8 and 49.9, respectively, P < 0.001) as compared to other traditional uterine factors (>50% myometrial tumor invasion, cervical stromal invasion, and adnexal involvement: incidence range 30.4-37.9%, odds ratio range 3.80-7.03). Deep and extensive of LVSI patterns were both significantly correlated to distant recurrence (P < 0.001). Among women who received postoperative chemotherapy, deep and extensive LVSI patterns did not have increased risks for distant recurrence compared to no LVSI (P = 0.47 and 0.32, respectively). Among women who received postoperative radiotherapy, the depth of LVSI was significantly associated with recurrence outside the radiated field (P = 0.02).
  
  
  CONCLUSIONS
  Depth and extent of LVSI are important predictors for lymph node metastasis and distant recurrence in endometrial cancer.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California.|Norris Comprehensive Cancer Center, University of Southern California, California.
authors.forename: Koji
authors.initials: K
authors.lastname: Matsuo
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California.
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Garcia-Sayre
authors.affiliation: Department of Pathology, University of Southern California, Los Angeles, California.
authors.forename: Fabiola
authors.initials: F
authors.lastname: Medeiros
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California.
authors.forename: Jennifer K
authors.initials: JK
authors.lastname: Casabar
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Machida
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California.
authors.forename: Aida
authors.initials: A
authors.lastname: Moeini
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California.|Norris Comprehensive Cancer Center, University of Southern California, California.
authors.forename: Lynda D
authors.initials: LD
authors.lastname: Roman
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D016022:Case-Control Studies; D003131:Combined Modality Therapy; D018284:Cystadenocarcinoma, Serous / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D016889:Endometrial Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009215:Myometrium / Q000473:pathology*; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D009367:Neoplasm Staging; D011379:Prognosis; D017154:Stromal Cells / Q000473:pathology*; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy
keywords: chemotherapy; endometrial cancer; lymph node metastasis; lymphovascular space invasion; radiotherapy; recurrence