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Is Substantial Lymphovascular Space Invasion Prognostic for Clinical Outcomes in Type II Endometrial Cancer?
S Jaishankar1, P M Pifer1, R Bhargava2
1Department of Radiation Oncology, UPMC Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Substantial lymphovascular space invasion (LVSI) is common in type II endometrial cancer and predicts lymph node involvement. This finding highlights LVSI as a critical prognostic factor for patient outcomes.
Area of Science:
- Gynecologic Oncology
- Pathology
- Cancer Research
Background:
- Lymphovascular space invasion (LVSI) is a known prognostic indicator in endometrioid endometrial carcinoma.
- The prognostic significance of LVSI in type II endometrial cancer (clear cell and serous subtypes) requires further elucidation.
Purpose of the Study:
- To determine the incidence of substantial LVSI in type II endometrial cancer.
- To correlate the extent of LVSI with clinical outcomes, including lymph node involvement and survival rates.
Main Methods:
- Retrospective review of 79 type II endometrial cancer patients treated surgically from July 2017 to December 2019.
- Utilized a three-tier LVSI scoring system and statistical analyses (logistic regression, Cox regression, Kaplan-Meier, Log-rank test).
Main Results:
- Substantial LVSI was present in 36.7% of patients.
- Lymph node involvement was significantly higher in patients with substantial LVSI (60.0%) compared to none/focal LVSI (0.0-20.0%, P < 0.001).
- Two-year locoregional disease-free survival (LR-DFS) and distant metastasis disease-free survival (DM-DFS) were significantly lower in patients with substantial LVSI.
Conclusions:
- Substantial LVSI occurs frequently in type II endometrial cancer.
- LVSI is a significant predictor of lymph node metastasis and adverse clinical outcomes in this patient population.
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