Cancers (May 2023)

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

  • 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

DOI
https://doi.org/10.3390/cancers15092612
Journal volume & issue
Vol. 15, no. 9
p. 2612

Abstract

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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.

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