Comparison of Survival Outcomes of Lymphovascular Space Invasion-Negative and Lymphovascular Space Invasion - Positive Women with Stage IIIC Endometrioid Endometrial Cancer: A Case - Control Study
Keywords:Endometrioid - type endometrial cancer, Lymphovascular space invasion, Stage IIIC disease, Overall survival
Objective: The purpose of this case-control study was to investigate the effect of lymphovascular space invasion on recurrence patterns and survival in patients with stage IIIC endometrioid type endometrial cancer.
Study Design: A multicenter, retrospective, department database review was performed to identify lymphovascular space invasion-negative and lymphovascular space invasion-positive stage IIIC endometrioid endometrial cancer at five gynecological oncology centers in Turkey. Demographic, clinicopathological and survival data were collected. Cases and controls were matched in terms of age at diagnosis, grade of tumor, depth of myometrial invasion, sub-stage and adjuvant treatment.
Results: Forty-one patients in the case group and 82 patients in the control group were eligible for the study. The 5-year OS rates were 94.4% in the lymphovascular space invasion-negative group and 77.2% in the LVSI-positive group (p=0.058). Advanced age (58 years) (HR 3.73; 95% CI: 1.19-11.69, p=0.02), grade 3 tumor (HR 2.57; 95% CI: 1.002-6.62, p=0.048) and cervical involvement (HR 2.62; 95% CI: 1.03-6.67, p= 0.04) appeared to be as independent predictors of decreased overall survival (OS). There was a trend towards statistical significance between the presence of lymphovascular space invasion and OS in regression analysis (HR 3.10; 95% CI 0.90-10.67, p=0.05). Recurrence rates were 17.0% (7/41) and 24.4% (20/82) in lymphovascular space invasion-negative and lymphovascular space invasion-positive groups, respectively (p=0.48). There were 5 cases of retroperitoneal recurrences in the lymphovascular space invasion-positive group and no retroperitoneal recurrence among lymphovascular space invasion-negative women.
Conclusion: Lymphovascular space invasion status seems to be of borderline significance for OS in stage IIIC endometrioid endometrial cancer and impacts recurrence patterns as retroperitoneal recurrences are strongly related to positive lymphovascular space invasion status.
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