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Lymphovascular Space Invasion in Early-Stage Endometrial Cancer (LySEC): Patterns of Recurrence and Predictors. A Multicentre Retrospective Cohort Study of the Spain Gynecologic Oncology Group

Authors :
Group, M. Reyes Oliver-Perez
Pablo Padilla-Iserte
Octavio Arencibia-Sanchez
Cristina Martin-Arriscado
Juan Carlos Muruzabal
Berta Diaz-Feijóo
Silvia Cabrera
Pluvio Coronado
M. Belen Martín-Salamanca
Manuel Pantoja-Garrido
Josefa Marcos-Sanmartin
Elena Cabezas-López
Cristina Lorenzo
Duska Beric
Jose Ramon Rodriguez-Hernandez
Fernando Roldan-Rivas
Juan Gilabert-Estelles
Lourdes Sanchez
Maria Laseca-Modrego
Carmen Tauste-Rubio
Blanca Gil-Ibañez
Alvaro Tejerizo-Garcia
on behalf of the Spain-GOG Group on behalf of the Spain-GOG
Source :
Cancers; Volume 15; Issue 9; Pages: 2612
Publication Year :
2023
Publisher :
Multidisciplinary Digital Publishing Institute, 2023.

Abstract

The main aim is to compare oncological outcomes and patterns of recurrence of patients with early-stage endometrioid endometrial cancer according to lymphovascular space invasion (LVSI) status. The secondary objective is to determine preoperative predictors of LVSI. We performed a multicenter retrospective cohort study. A total of 3546 women diagnosed with postoperative early-stage (FIGO I-II, 2009) endometrioid endometrial cancer were included. Co-primary endpoints were disease-free survival (DFS), overall survival (OS), and pattern of recurrence. Cox proportional hazard models were used for time-to-event analysis. Univariate and multivariate logistical regression models were employed. Positive LVSI was identified in 528 patients (14.6%) and was an independent prognostic factor for DFS (HR 1.8), OS (HR 2.1) and distant recurrences (HR 2.37). Distant recurrences were more frequent in patients with positive LVSI (78.2% vs. 61.3%, p < 0.01). Deep myometrial invasion (OR 3.04), high-grade tumors (OR 2.54), cervical stroma invasion (OR 2.01), and tumor diameter ≥ 2 cm (OR 2.03) were independent predictors of LVSI. In conclusion, in these patients, LVSI is an independent risk factor for shorter DFS and OS, and distant recurrence, but not for local recurrence. Deep myometrial invasion, cervical stroma invasion, high-grade tumors, and a tumor diameter ≥ 2 cm are independent predictors of LVSI.

Details

Language :
English
ISSN :
20726694
Database :
OpenAIRE
Journal :
Cancers; Volume 15; Issue 9; Pages: 2612
Accession number :
edsair.multidiscipl..8055f93d7ac1ba6a58fdec09caf4a175
Full Text :
https://doi.org/10.3390/cancers15092612