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Erschienen in:
01.01.2011 | Gynecologic Oncology
Lymph-Vascular Space Invasion as a Significant Risk Factor for Isolated Para-aortic Lymph Node Metastasis in Endometrial Cancer: A Study of 203 Consecutive Patients
Erschienen in: Annals of Surgical Oncology | Ausgabe 1/2011
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Background
The purpose of this study was to investigate various pathologic risk factors associated with para-aortic lymph node metastasis (LNM) in surgically staged patients with endometrial cancer.
Materials and Methods
We performed a retrospective analysis of 203 consecutive patients with endometrial cancer who were surgically staged from 2000 to 2009. The association among the various pathologic variables for para-aortic LNM was determined with univariate and multivariate analyses.
Results
Of 203 patients, 29 patients (14.3%) had LNM. Also, 10 patients (4.9%) had only pelvic LNM, 14 (6.9%) had both pelvic and para-aortic LNM, and 5 (2.5%) had para-aortic LNM without pelvic LN involvements. Histologic type (P = .001), tumor grade (P < .001), tumor size (P = .003), depth of myometrial invasion (P < .001), cervical invasion (P < .001), parametrial invasion (P = .002), lymph-vascular space invasion (LVSI) (P < .001), serosal/adnexal invasion (P < .001), positive cytology (P = .002), peritoneal seeding (P < .001), and pelvic LNM (P < .001) were significant pathologic factors for para-aortic LNM. On multivariate analysis, cervical invasion (P = .032), LVSI (P = .018), and positive pelvic LNs (P = .002) were independent factors for para-aortic LNM. With regard to isolated para-aortic LNM, tumor grade (P = .017) and LVSI (P = .002) were significant factors for LN involvements. On multivariate analysis, LVSI (P = .004) was the only significant independent factor.
Conclusions
LVSI correlates significantly with the risk of isolated para-aortic LNM in endometrial cancer patients.