Files and links (1)
Accepted (AM)Open Access (License Unspecified), Open
Journal article
Is Substantial Lymphovascular Space Invasion Prognostic in Patients With Pathologically Lymph Node-Negative Endometrial Cancer?
International journal of radiation oncology, biology, physics, v 117(1), pp 148-153
01 Sep 2023
PMID: 36893818
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Purpose: Lymphovascular space invasion (LVSI) predicts for higher rates of recurrence and increased mortality in endometrial cancer. Using 3-tier LVSI scoring, a PORTEC-1 and-2 trials analysis demonstrated that substantial LVSI was associated with worse locoregional (LR-DFS) and distant metastasis disease-free survival (DM-DFS), and these patients possibly benefited from external beam radiation therapy (EBRT). Furthermore, LVSI is a predictor for lymph node (LN) involvement, but the significance of substantial LVSI is unknown in patients with a pathologically negative LN assessment. We aimed to evaluate clinical outcomes of these patients in relation to the 3-tier LVSI scoring system.Methods and Materials: We performed a single-institutional retrospective review of patients with stage I endometrioid-type endometrial cancer who underwent surgical staging with pathologically negative LN evaluation from 2017 to 2019 with 3-tier LVSI scoring (none, focal, or substantial). Clinical outcomes (LR-DFS, DM-DFS, and overall survival) were analyzed using the Kaplan-Meier method.Results: A total of 335 patients with pathologically LN-negative stage I endometrioid-type endometrial carcinoma were identified. Substantial LVSI was present in 17.6% of patients; 39.7% of patients received adjuvant vaginal brachytherapy and 6.9% of patients received EBRT. Adjuvant radiation treatment varied by LVSI status. In patients with focal LVSI, 81.0% received vaginal brachytherapy. Among patients with substantial LVSI, 57.9% received vaginal brachytherapy alone, and 31.6% of patients received EBRT. The 2-year LR-DFS rates were 92.5%, 98.0%, and 91.4% for no LVSI, focal LVSI, and substantial LVSI, respectively. The 2-year DM-DFS rates were 95.5%, 93.3%, and 93.8% for no LVSI, focal LVSI, and substantial LVSI, respectively.Conclusions: In our institutional study, patients with pathologically LN-negative stage I endometrial cancer with substantial LVSI had similar rates of LR-DFS and DM-DFS compared with patients with none or focal LVSI. These findings highlight the need for multi institutional studies to validate the prognostic value of substantial LVSI in this patient population.& COPY; 2023 Elsevier Inc. All rights reserved.
Metrics
Details
- Title
- Is Substantial Lymphovascular Space Invasion Prognostic in Patients With Pathologically Lymph Node-Negative Endometrial Cancer?
- Creators
- Phillip M. Pifer - University of Pittsburgh Medical CenterSruthi Jaishankar - University of Pittsburgh Medical CenterRohit Bhargava - Magee-Womens HospitalMichael D. Schad - University of Pittsburgh Medical CenterAndrew Keller - UPMC Hillman Cancer CenterHima Bindu Musunuru - University of Pittsburgh Medical CenterMichael Cohen - Magee-Womens HospitalPaniti Sukumvanich - University of Pittsburgh Medical CenterMadeleine Courtney-Brooks - University of PittsburghMichelle Boisen - Magee-Womens HospitalJessica L. Berger - Magee-Womens HospitalAlexander Olawaiye - Magee-Womens HospitalJamie Lesnock - Magee-Womens HospitalRobert Edwards - Magee-Womens HospitalSarah Taylor - Magee-Womens HospitalJohn Austin Vargo - UPMC Hillman Cancer CenterSushil Beriwal - Varian Medical Systems
- Publication Details
- International journal of radiation oncology, biology, physics, v 117(1), pp 148-153
- Publisher
- Elsevier
- Number of pages
- 6
- Grant note
- Varian Medical Systems
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Radiation Oncology (and Nuclear Medicine)
- Web of Science ID
- WOS:001069596900001
- Scopus ID
- 2-s2.0-85153327048
- Other Identifier
- 991021897392004721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Oncology
- Radiology, Nuclear Medicine & Medical Imaging