Prognostic impact of satellite-lymphovascular space involvement in early-stage cervical cancer

Currently the prognostic value of lymphovascular space involvement (LVSI) in patients with cervical cancer is unclear. We evaluated the prognostic impact of different categories of LVSI on overall survival (OAS) and disease-free survival (DFS) in a Middle-European population of women with surgically staged, early cervical cancer. The records of 281 women with clinically and histologically diagnosed early cervical cancer undergoing primary surgical treatment at the University of Ulm School of Medicine between 1992 and 2006 were retrospectively reviewed. LVSI as determined by hematoxylin-eosin staining was topographically categorized as conjoined-LVSI and satellite-LVSI. The effect of LVSI, tumor stage, lymph node metastases, and histology on OAS and DFS was assessed by Cox regression analyses. Tumor size and nodal status could be confirmed as significant prognostic factors for OAS and DFS in early-stage cervical cancer. While no significant effect of LVSI in general (satellite-LVSI or conjoined-LVSI) on OAS and DFS was calculated, the presence of satellite-LVSI was associated with significant decreased rates of both, OAS and DFS. We propose satellite-LVSI as new risk factor for patients with early-stage cervical cancer, in order to better identify the patients urgently needing adjuvant therapy.