Cusano E, et al. - Researchers investigated the prognostic significance of lymphovascular space invasion (LVSI) in pathologic node-negative surgically staged (T1N0) endometrial cancer patients. LVSI was an independent risk factor for worse overall survival, even after adjusting for other factors. Therefore, they recommend considering LVSI status while estimating the overall survival in patients with early-stage, node-negative endometrial cancer.

Methods

• Researchers performed a retrospective cohort study including all patients with pathologic stage T1N0 endometrial carcinoma treated at The Ottawa Hospital Cancer Centre from 1998 to 2007.
• Collection of patient demographics, pathologic findings, treatment, and outcome data was performed.
• They used univariate and multivariate cox regression modeling to determine significance and adjust for demographic and histopathologic covariates.
• The 5-year overall and recurrence-free survival were estimated using Kaplan-Meier curves.

Results

• Four hundred pathologic stage T1N0 patients who received an initial total hysterectomy and bilateral salpingo-oophorectomy with lymphadenectomy were included.
• The median age at diagnosis was 62 years; the median follow-up was 66 months.
• A positive LVSI status was observed in 54 patients (13.5%); 346 (86.5%) patients showed a negative LVSI status.
• Patients without LVSI showed a 5-year overall survival of 97.3% vs 90.9% in those with LVSI (P < 0.001).
• Patients without LVSI had a 5-year recurrence-free survival of 95.2% vs 85.9% in those with LVSI (P=0.006).
• As per univariate analysis, grade, stage, and LVSI were the covariates that were significantly associated with time to recurrence, and age, grade, stage, and LVSI were significantly associated with overall survival.
• No significant covariates for recurrence-free survival were noted by multivariate analysis; only age and LVSI were noted to be significant for overall survival.