Is Substantial Lymphovascular Space Invasion Prognostic in Patients With Pathologically Lymph Node-Negative Endometrial Cancer?

医学 子宫内膜癌 内科学 肿瘤科 阶段(地层学) 近距离放射治疗 淋巴结 放射治疗 淋巴血管侵犯 放射科 癌症 转移 古生物学 生物
作者
Phillip M. Pifer,Sruthi Jaishankar,Rohit Bhargava,Michael D. Schad,A. Keller,Hima Bindu Musunuru,Michael R. Cohen,Paniti Sukumvanich,Madeleine Courtney‐Brooks,M.M. Boisen,Jessica Berger,Alexander Olawaiye,Jamie Lesnock,Robert P. Edwards,Sarah Taylor,John A. Vargo,Sushil Beriwal
出处
期刊:International Journal of Radiation Oncology Biology Physics [Elsevier]
卷期号:117 (1): 148-153 被引量:2
标识
DOI:10.1016/j.ijrobp.2023.02.053
摘要

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. 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. 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. 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. 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.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
大幅提高文件上传限制,最高150M (2024-4-1)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
monere应助两清采纳,获得10
刚刚
1秒前
1秒前
溪鱼完成签到,获得积分10
1秒前
1秒前
2秒前
可爱mini完成签到,获得积分10
3秒前
3秒前
3秒前
李健的小迷弟应助打我呀采纳,获得10
3秒前
无私代容完成签到,获得积分10
4秒前
夏昱发布了新的文献求助20
4秒前
5秒前
优秀素明发布了新的文献求助10
5秒前
王木木发布了新的文献求助10
6秒前
早起完成签到,获得积分10
8秒前
8秒前
8秒前
畅快的鲂发布了新的文献求助10
8秒前
流云完成签到,获得积分10
8秒前
9秒前
活泼岩发布了新的文献求助10
10秒前
11秒前
lily完成签到,获得积分10
11秒前
11秒前
李小鑫吖完成签到,获得积分10
12秒前
12秒前
hqn完成签到 ,获得积分10
12秒前
14秒前
酷波er应助singxu采纳,获得10
14秒前
Jianjiama发布了新的文献求助10
14秒前
15秒前
科研巨星发布了新的文献求助10
15秒前
冷静的笑寒-晴天完成签到,获得积分10
15秒前
SaSa发布了新的文献求助10
16秒前
16秒前
Akim应助优秀的冬天采纳,获得10
16秒前
晴天完成签到,获得积分10
17秒前
飞火发布了新的文献求助10
17秒前
烟花应助chadzhu采纳,获得10
19秒前
高分求助中
The late Devonian Standard Conodont Zonation 2000
The Lali Section: An Excellent Reference Section for Upper - Devonian in South China 1500
Nickel superalloy market size, share, growth, trends, and forecast 2023-2030 1000
Smart but Scattered: The Revolutionary Executive Skills Approach to Helping Kids Reach Their Potential (第二版) 1000
Mantiden: Faszinierende Lauerjäger Faszinierende Lauerjäger 800
PraxisRatgeber: Mantiden: Faszinierende Lauerjäger 800
A new species of Coccus (Homoptera: Coccoidea) from Malawi 500
热门求助领域 (近24小时)
化学 医学 生物 材料科学 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 基因 遗传学 催化作用 物理化学 免疫学 量子力学 细胞生物学
热门帖子
关注 科研通微信公众号,转发送积分 3246288
求助须知:如何正确求助?哪些是违规求助? 2889774
关于积分的说明 8260109
捐赠科研通 2558231
什么是DOI,文献DOI怎么找? 1387056
科研通“疑难数据库(出版商)”最低求助积分说明 650416
邀请新用户注册赠送积分活动 626861