Extent of lymphovascular space invasion may predict lymph node metastasis in uterine serous carcinoma

Yushen Qian, Erqi L. Pollom, Chika Nwachukwu, Kira Seiger, Rie von Eyben, Ann K. Folkins, Elizabeth A. Kidd

Research output: Contribution to journalArticle

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Abstract

Objectives Emerging evidence suggests that extent of lymphovascular space invasion (LVSI) predicts for risk of lymph node metastasis in endometrioid uterine cancers. However, this correlation remains unknown in the setting of uterine serous carcinoma (USC). We sought to examine the association between extent of LVSI and other histopathologic characteristics with risk of nodal metastasis for women with USC. Materials/methods Pathological data from all cases of uterine serous carcinoma between July 1998 to July 2015 at our institution were reviewed. Descriptive, univariate, and multivariate logistic regression analysis of selected pathologic features were performed. Results 88 patients with USC underwent total abdominal or laparoscopic hysterectomy, bilateral salpingo-oophorectomy, and selective lymphadenectomy. Surgical staging revealed the following FIGO stage distributions: I (41%), II (8%), III (32%), IV (19%). LVSI was present in 44 (50%) patients. 36 patients (41%) had LN metastases with median number of total nodes removed of 17 (range, 1–49). On univariate analysis, depth of myometrial invasion, LVSI, tumor size, and cervical stromal involvement were significantly associated with nodal involvement. In a multivariate model, LVSI (OR 6.25, 95% CI 2.2–18.0, p < 0.01) and cervical stromal involvement (OR 3.33, 95% CI 1.10–10.0, p = 0.03) were the only factors that remained significant. Among patients with LVSI-positive disease, extensive LVSI was associated with increased risk of nodal involvement compared to focal LVSI (90% vs 29%, p = 0.04). Conclusions Presence and extent of LVSI, and cervical stromal invasion are important predictors for lymph node metastasis in uterine serous carcinoma.

Original languageEnglish (US)
Pages (from-to)24-29
Number of pages6
JournalGynecologic Oncology
Volume147
Issue number1
DOIs
StatePublished - Oct 2017
Externally publishedYes

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Lymph Nodes
Neoplasm Metastasis
Carcinoma
Uterine Neoplasms
Ovariectomy
Lymph Node Excision
Hysterectomy
Logistic Models
Regression Analysis
Neoplasms

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

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Extent of lymphovascular space invasion may predict lymph node metastasis in uterine serous carcinoma. / Qian, Yushen; Pollom, Erqi L.; Nwachukwu, Chika; Seiger, Kira; von Eyben, Rie; Folkins, Ann K.; Kidd, Elizabeth A.

In: Gynecologic Oncology, Vol. 147, No. 1, 10.2017, p. 24-29.

Research output: Contribution to journalArticle

Qian, Yushen ; Pollom, Erqi L. ; Nwachukwu, Chika ; Seiger, Kira ; von Eyben, Rie ; Folkins, Ann K. ; Kidd, Elizabeth A. / Extent of lymphovascular space invasion may predict lymph node metastasis in uterine serous carcinoma. In: Gynecologic Oncology. 2017 ; Vol. 147, No. 1. pp. 24-29.
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title = "Extent of lymphovascular space invasion may predict lymph node metastasis in uterine serous carcinoma",
abstract = "Objectives Emerging evidence suggests that extent of lymphovascular space invasion (LVSI) predicts for risk of lymph node metastasis in endometrioid uterine cancers. However, this correlation remains unknown in the setting of uterine serous carcinoma (USC). We sought to examine the association between extent of LVSI and other histopathologic characteristics with risk of nodal metastasis for women with USC. Materials/methods Pathological data from all cases of uterine serous carcinoma between July 1998 to July 2015 at our institution were reviewed. Descriptive, univariate, and multivariate logistic regression analysis of selected pathologic features were performed. Results 88 patients with USC underwent total abdominal or laparoscopic hysterectomy, bilateral salpingo-oophorectomy, and selective lymphadenectomy. Surgical staging revealed the following FIGO stage distributions: I (41{\%}), II (8{\%}), III (32{\%}), IV (19{\%}). LVSI was present in 44 (50{\%}) patients. 36 patients (41{\%}) had LN metastases with median number of total nodes removed of 17 (range, 1–49). On univariate analysis, depth of myometrial invasion, LVSI, tumor size, and cervical stromal involvement were significantly associated with nodal involvement. In a multivariate model, LVSI (OR 6.25, 95{\%} CI 2.2–18.0, p < 0.01) and cervical stromal involvement (OR 3.33, 95{\%} CI 1.10–10.0, p = 0.03) were the only factors that remained significant. Among patients with LVSI-positive disease, extensive LVSI was associated with increased risk of nodal involvement compared to focal LVSI (90{\%} vs 29{\%}, p = 0.04). Conclusions Presence and extent of LVSI, and cervical stromal invasion are important predictors for lymph node metastasis in uterine serous carcinoma.",
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AU - Pollom, Erqi L.

AU - Nwachukwu, Chika

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AU - von Eyben, Rie

AU - Folkins, Ann K.

AU - Kidd, Elizabeth A.

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N2 - Objectives Emerging evidence suggests that extent of lymphovascular space invasion (LVSI) predicts for risk of lymph node metastasis in endometrioid uterine cancers. However, this correlation remains unknown in the setting of uterine serous carcinoma (USC). We sought to examine the association between extent of LVSI and other histopathologic characteristics with risk of nodal metastasis for women with USC. Materials/methods Pathological data from all cases of uterine serous carcinoma between July 1998 to July 2015 at our institution were reviewed. Descriptive, univariate, and multivariate logistic regression analysis of selected pathologic features were performed. Results 88 patients with USC underwent total abdominal or laparoscopic hysterectomy, bilateral salpingo-oophorectomy, and selective lymphadenectomy. Surgical staging revealed the following FIGO stage distributions: I (41%), II (8%), III (32%), IV (19%). LVSI was present in 44 (50%) patients. 36 patients (41%) had LN metastases with median number of total nodes removed of 17 (range, 1–49). On univariate analysis, depth of myometrial invasion, LVSI, tumor size, and cervical stromal involvement were significantly associated with nodal involvement. In a multivariate model, LVSI (OR 6.25, 95% CI 2.2–18.0, p < 0.01) and cervical stromal involvement (OR 3.33, 95% CI 1.10–10.0, p = 0.03) were the only factors that remained significant. Among patients with LVSI-positive disease, extensive LVSI was associated with increased risk of nodal involvement compared to focal LVSI (90% vs 29%, p = 0.04). Conclusions Presence and extent of LVSI, and cervical stromal invasion are important predictors for lymph node metastasis in uterine serous carcinoma.

AB - Objectives Emerging evidence suggests that extent of lymphovascular space invasion (LVSI) predicts for risk of lymph node metastasis in endometrioid uterine cancers. However, this correlation remains unknown in the setting of uterine serous carcinoma (USC). We sought to examine the association between extent of LVSI and other histopathologic characteristics with risk of nodal metastasis for women with USC. Materials/methods Pathological data from all cases of uterine serous carcinoma between July 1998 to July 2015 at our institution were reviewed. Descriptive, univariate, and multivariate logistic regression analysis of selected pathologic features were performed. Results 88 patients with USC underwent total abdominal or laparoscopic hysterectomy, bilateral salpingo-oophorectomy, and selective lymphadenectomy. Surgical staging revealed the following FIGO stage distributions: I (41%), II (8%), III (32%), IV (19%). LVSI was present in 44 (50%) patients. 36 patients (41%) had LN metastases with median number of total nodes removed of 17 (range, 1–49). On univariate analysis, depth of myometrial invasion, LVSI, tumor size, and cervical stromal involvement were significantly associated with nodal involvement. In a multivariate model, LVSI (OR 6.25, 95% CI 2.2–18.0, p < 0.01) and cervical stromal involvement (OR 3.33, 95% CI 1.10–10.0, p = 0.03) were the only factors that remained significant. Among patients with LVSI-positive disease, extensive LVSI was associated with increased risk of nodal involvement compared to focal LVSI (90% vs 29%, p = 0.04). Conclusions Presence and extent of LVSI, and cervical stromal invasion are important predictors for lymph node metastasis in uterine serous carcinoma.

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