OBJECTIVE: Adjuvant radiotherapy improves local control but not survival in women with endometrial cancer. This benefit was shown in staged patients with "high intermediate risk" (HIR) disease. Other studies have challenged the need for systematic staging including lymphadenectomy. We sought to determine whether LVSI alone or in combination with other histologic factors predicts lymph node (LN) metastasis in patients with endometrioid endometrial cancer. METHODS: A retrospective review was conducted of patients with endometrioid endometrial carcinoma who had confirmed presence/absence of LVSI and clinicopathologic data necessary to identify HIR criteria. Kaplan-Meier curves were generated and univariate and multivariate analyses performed as appropriate. RESULTS: We identified 757 eligible patients and 628 underwent systematic lymphadenectomy for staging purposes. In the surgically staged group, 242 (38%) patients met uterine HIR criteria and 196 (31%) had LVSI. Both HIR and LVSI were significantly associated with LN metastasis. Among the HIR positive group, 59 had LN metastasis (OR 4.46, 95% CI 2.72-7.32, P<0.0001). Sixty-six LVSI positive patients had nodal metastasis (OR 11.04, 95% CI 6.39-19.07, P<0.0001). The NPV of LVSI and HIR negative specimens was 95.6% and 93.4% respectively. In multivariate analysis, PFS and OS were significantly reduced in both LVSI positive (P<0.0001) and HIR patients (P<0.0001) when compared to patients who were LVSI and HIR negative. CONCLUSIONS: HIR status and LVSI are highly associated with LN metastasis. These features are useful in assessing risk of metastatic disease and may serve as a surrogate for prediction of extrauterine disease.
OBJECTIVE: Adjuvant radiotherapy improves local control but not survival in women with endometrial cancer. This benefit was shown in staged patients with "high intermediate risk" (HIR) disease. Other studies have challenged the need for systematic staging including lymphadenectomy. We sought to determine whether LVSI alone or in combination with other histologic factors predicts lymph node (LN) metastasis in patients with endometrioid endometrial cancer. METHODS: A retrospective review was conducted of patients with endometrioid endometrial carcinoma who had confirmed presence/absence of LVSI and clinicopathologic data necessary to identify HIR criteria. Kaplan-Meier curves were generated and univariate and multivariate analyses performed as appropriate. RESULTS: We identified 757 eligible patients and 628 underwent systematic lymphadenectomy for staging purposes. In the surgically staged group, 242 (38%) patients met uterine HIR criteria and 196 (31%) had LVSI. Both HIR and LVSI were significantly associated with LN metastasis. Among the HIR positive group, 59 had LN metastasis (OR 4.46, 95% CI 2.72-7.32, P<0.0001). Sixty-six LVSI positive patients had nodal metastasis (OR 11.04, 95% CI 6.39-19.07, P<0.0001). The NPV of LVSI and HIR negative specimens was 95.6% and 93.4% respectively. In multivariate analysis, PFS and OS were significantly reduced in both LVSI positive (P<0.0001) and HIR patients (P<0.0001) when compared to patients who were LVSI and HIR negative. CONCLUSIONS: HIR status and LVSI are highly associated with LN metastasis. These features are useful in assessing risk of metastatic disease and may serve as a surrogate for prediction of extrauterine disease.
Authors: Matias E Valsecchi; Damian Silbermins; Nicole de Rosa; Sandra L Wong; Gary H Lyman Journal: J Clin Oncol Date: 2011-03-07 Impact factor: 44.544
Authors: Justine M Briët; Harry Hollema; Nathalie Reesink; Jan G Aalders; Marian J E Mourits; Klaske A ten Hoor; Elisabeth Pras; H Marike Boezen; Ate G J van der Zee; Hans W Nijman Journal: Gynecol Oncol Date: 2005-03 Impact factor: 5.482
Authors: C L Creutzberg; W L van Putten; P C Koper; M L Lybeert; J J Jobsen; C C Wárlám-Rodenhuis; K A De Winter; L C Lutgens; A C van den Bergh; E van de Steen-Banasik; H Beerman; M van Lent Journal: Lancet Date: 2000-04-22 Impact factor: 79.321
Authors: Janiel M Cragun; Laura J Havrilesky; Brian Calingaert; Ingrid Synan; Angeles Alvarez Secord; John T Soper; Daniel L Clarke-Pearson; Andrew Berchuck Journal: J Clin Oncol Date: 2005-02-28 Impact factor: 44.544
Authors: L C Kilgore; E E Partridge; R D Alvarez; J M Austin; H M Shingleton; F Noojin; W Conner Journal: Gynecol Oncol Date: 1995-01 Impact factor: 5.482
Authors: John K Chan; Renata Urban; Michael K Cheung; Jacob Y Shin; Amreen Husain; Nelson N Teng; Jonathan S Berek; Joan L Walker; Daniel S Kapp; Kathryn Osann Journal: Cancer Date: 2007-06-15 Impact factor: 6.860
Authors: Henry M Keys; James A Roberts; Virginia L Brunetto; Richard J Zaino; Nick M Spirtos; Jeffrey D Bloss; Andrew Pearlman; Mitchell A Maiman; Jeffrey G Bell Journal: Gynecol Oncol Date: 2004-03 Impact factor: 5.482
Authors: Sarah B Fisher; Sameer H Patel; David A Kooby; Sharon Weber; Mark Bloomston; Clifford Cho; Ioannis Hatzaras; Carl Schmidt; Emily Winslow; Charles A Staley; Shishir K Maithel Journal: HPB (Oxford) Date: 2012-05-22 Impact factor: 3.647
Authors: Yushen Qian; Erqi L Pollom; Chika Nwachukwu; Kira Seiger; Rie von Eyben; Ann K Folkins; Elizabeth A Kidd Journal: Gynecol Oncol Date: 2017-07-11 Impact factor: 5.482
Authors: Ricardo dos Reis; Jennifer K Burzawa; Audrey T Tsunoda; Masayoshi Hosaka; Michael Frumovitz; Shannon N Westin; Mark F Munsell; Pedro T Ramirez Journal: Int J Gynecol Cancer Date: 2015-09 Impact factor: 3.437
Authors: Wan Adnan Wan Nor Asyikeen; Ab Hamid Siti-Azrin; Nur Asyilla Che Jalil; Anani Aila Mat Zin; Nor Hayati Othman Journal: Malays J Med Sci Date: 2016-12-07
Authors: Koji Matsuo; Todd B Sheridan; Seiji Mabuchi; Kiyoshi Yoshino; Kosei Hasegawa; Kimberley D Studeman; Dwight D Im; Neil B Rosenshein; Lynda D Roman; Anil K Sood Journal: Gynecol Oncol Date: 2014-03-25 Impact factor: 5.482