Balaya Vincent, Guani Benedetta, Magaud Laurent, Bonsang-Kitzis Hélène, Ngô Charlotte, Mathevet Patrice, Lécuru Fabrice
Gynecology Department, Centre hospitalo-universitaire vaudois, 1011 Lausanne, Switzerland.
Faculty of Biology and Medicine, University of Lausanne, 1015 Lausanne, Switzerland.
Cancers (Basel). 2020 Nov 28;12(12):3554. doi: 10.3390/cancers12123554.
The aim of this study was to assess the prognostic impact of Lymphovascular space invasion (LVSI) in IB1 stage of the revised 2018 International Federation of Gynecology and Obstetrics (FIGO) classification for cervical cancer.
A secondary analysis of two French prospective multicentric trials on Sentinel Lymph node biopsy for cervical cancer was performed. Patients with 2009 FIGO IB1 stage who underwent radical surgery between January 2005 and July 2012 from 28 French expert centers were included. The stage was modified retrospectively according to the new 2018 FIGO staging system.
According to the 2009 FIGO classification, 246 patients had IB1 disease stage and fulfilled the inclusion criteria. The median follow-up was 48 months (4-127). Twenty patients (8.1%) experienced a recurrence, and the 5-year Disease Free Survival (DFS) was 90.0%. Compared to 2018 IB1 staged patients, new IB2 had significantly decreased 5-year DFS, 78.6% vs. 92.9%, = 0.006 whereas IIIC patients had similar 5-year DFS (91.7%, = 0.95). In the subgroup of patients with FIGO 2018 IB1 stage, the presence of LVSI was associated with a significant decrease in DFS (82.5% vs. 95.8%, = 0.04).
LVSI is associated with decreased 5-year DFS in IB1 2018 FIGO stage and LVSI status should be considered in early-stage cervical cancer for a more precise risk assessment.
本研究旨在评估2018年国际妇产科联盟（FIGO）修订的宫颈癌分期中IB1期淋巴管血管间隙浸润（LVSI）的预后影响。
对两项关于宫颈癌前哨淋巴结活检的法国前瞻性多中心试验进行二次分析。纳入2005年1月至2012年7月间来自28个法国专家中心接受根治性手术的2009年FIGO IB1期患者。根据新的2018年FIGO分期系统对分期进行回顾性修改。
根据2009年FIGO分类，246例患者为IB1期疾病且符合纳入标准。中位随访时间为48个月（4 - 127个月）。20例患者（8.1%）出现复发，5年无病生存率（DFS）为90.0%。与2018年IB1期患者相比，新的IB2期患者5年DFS显著降低，分别为78.6%和92.9%，P = 0.006，而IIIC期患者5年DFS相似（91.7%，P = 0.95）。在2018年FIGO IB1期患者亚组中，LVSI的存在与DFS显著降低相关（82.5%对95.8%，P = 0.04）。
LVSI与2018年FIGO IB1期患者5年DFS降低相关，早期宫颈癌应考虑LVSI状态以进行更精确的风险评估。
