Department of Gynecologic Oncology, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Department of Gynecologic Oncology, Vali-Asr Hospital, Tehran University of Medical Sciences, Imam Khomeini Hospital Complex (IKHC), Tehran, Iran.
Eur J Med Res. 2023 Mar 13;28(1):118. doi: 10.1186/s40001-023-01084-9.
The lymphovascular space invasion (LVSI) is suggested as a prognostic factor for endometrial cancer in many studies, but it has not yet been employed in FIGO staging system. The present study was aimed to evaluate the impact of LVSI on survival in patients with early stage endometrioid endometrial cancer.
This retrospective cohort was conducted on early stage endometrial cancer patients who underwent surgical staging [total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH/BSO)] and omental biopsy at Referral Teaching Hospitals of Tehran from 2005 to 2021. Patient's age, menopause status, tumor grade, tumor size, depth of myometrial invasion, LVSI and lower segment involvement were recorded. Data were analyzed with SPSS 22.
415 patients with stage I and grade 1-2, endometrioid endometrial cancer were analyzed. 100 patients (24.1%) were LVSI-positive. 3-year and 5-year survival rates were 97.1% and 88.9%, respectively. Recurrence occurred in 53 patients (12.8%). 3-year overall survival rates in LVSI-negative and LVSI-positive were 98.7% and 92%. These rates for 5-year survival were 92.1% and 79%, respectively. Recurrence rates in LVSI-negative were 8.9% while it was 25% in LVSI-positive cases. Multivariate analysis showed that LVSI has significant correlation with 3-year and 5-year overall survival rates.
LVSI in early stage endometrial cancer significantly and independently influences 3-year and 5-year survival rates and acts as a strong prognostic factor in these patients. LVSI should be implemented in endometrial cancer staging systems due to its significant correlation with cancer recurrence rates and 5-year survival rates.
在许多研究中，淋巴血管空间侵犯（LVSI）被认为是子宫内膜癌的预后因素，但尚未纳入 FIGO 分期系统。本研究旨在评估 LVSI 对早期子宫内膜样型子宫内膜癌患者生存的影响。
本回顾性队列研究纳入了 2005 年至 2021 年在德黑兰转诊教学医院接受手术分期（全子宫切除术和双侧输卵管卵巢切除术（TAH/BSO））和网膜活检的早期子宫内膜癌患者。记录患者年龄、绝经状态、肿瘤分级、肿瘤大小、肌层浸润深度、LVSI 和下段受累情况。数据采用 SPSS 22 进行分析。
共分析了 415 例 I 期和 1-2 级子宫内膜样型子宫内膜癌患者，其中 100 例（24.1%）为 LVSI 阳性。3 年和 5 年生存率分别为 97.1%和 88.9%。53 例（12.8%）患者复发。LVSI 阴性和 LVSI 阳性患者的 3 年总生存率分别为 98.7%和 92%，5 年总生存率分别为 92.1%和 79%。LVSI 阴性患者的复发率为 8.9%，而 LVSI 阳性患者的复发率为 25%。多变量分析显示，LVSI 与 3 年和 5 年总生存率显著相关。
LVSI 对早期子宫内膜癌患者的 3 年和 5 年生存率有显著且独立的影响，是这些患者的强有力的预后因素。由于 LVSI 与癌症复发率和 5 年生存率显著相关，应将其纳入子宫内膜癌分期系统。
