Lymphovascular Space Invasion in Early-Stage Endometrial Cancer (LySEC): Patterns of Recurrence and Predictors. A Multicentre Retrospective Cohort Study of the Spain Gynecologic Oncology Group
The main aim is to compare oncological outcomes and patterns of recurrence of patients with early-stage endometrioid endometrial cancer according to lymphovascular space invasion (LVSI) status. The secondary objective is to determine preoperative predictors of LVSI. We performed a multicenter retros...
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| Veröffentlicht in: | Cancers 2023-05, Vol.15 (9), p.2612 |
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| creator | Oliver-Perez, M Reyes Padilla-Iserte, Pablo Arencibia-Sanchez, Octavio Martin-Arriscado, Cristina Muruzabal, Juan Carlos Diaz-Feijóo, Berta Cabrera, Silvia Coronado, Pluvio Martín-Salamanca, M Belen Pantoja-Garrido, Manuel Marcos-Sanmartin, Josefa Cabezas-López, Elena Lorenzo, Cristina Beric, Duska Rodriguez-Hernandez, Jose Ramon Roldan-Rivas, Fernando Gilabert-Estelles, Juan Sanchez, Lourdes Laseca-Modrego, Maria Tauste-Rubio, Carmen Gil-Ibañez, Blanca Tejerizo-Garcia, Alvaro On Behalf Of The Spain-Gog Group |
| description | The main aim is to compare oncological outcomes and patterns of recurrence of patients with early-stage endometrioid endometrial cancer according to lymphovascular space invasion (LVSI) status. The secondary objective is to determine preoperative predictors of LVSI. We performed a multicenter retrospective cohort study. A total of 3546 women diagnosed with postoperative early-stage (FIGO I-II, 2009) endometrioid endometrial cancer were included. Co-primary endpoints were disease-free survival (DFS), overall survival (OS), and pattern of recurrence. Cox proportional hazard models were used for time-to-event analysis. Univariate and multivariate logistical regression models were employed. Positive LVSI was identified in 528 patients (14.6%) and was an independent prognostic factor for DFS (HR 1.8), OS (HR 2.1) and distant recurrences (HR 2.37). Distant recurrences were more frequent in patients with positive LVSI (78.2% vs. 61.3%,
< 0.01). Deep myometrial invasion (OR 3.04), high-grade tumors (OR 2.54), cervical stroma invasion (OR 2.01), and tumor diameter ≥ 2 cm (OR 2.03) were independent predictors of LVSI. In conclusion, in these patients, LVSI is an independent risk factor for shorter DFS and OS, and distant recurrence, but not for local recurrence. Deep myometrial invasion, cervical stroma invasion, high-grade tumors, and a tumor diameter ≥ 2 cm are independent predictors of LVSI. |
| doi_str_mv | 10.3390/cancers15092612 |
| format | Article |
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< 0.01). Deep myometrial invasion (OR 3.04), high-grade tumors (OR 2.54), cervical stroma invasion (OR 2.01), and tumor diameter ≥ 2 cm (OR 2.03) were independent predictors of LVSI. In conclusion, in these patients, LVSI is an independent risk factor for shorter DFS and OS, and distant recurrence, but not for local recurrence. Deep myometrial invasion, cervical stroma invasion, high-grade tumors, and a tumor diameter ≥ 2 cm are independent predictors of LVSI.</description><identifier>ISSN: 2072-6694</identifier><identifier>EISSN: 2072-6694</identifier><identifier>DOI: 10.3390/cancers15092612</identifier><identifier>PMID: 37174081</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Cancer ; Cancer therapies ; Care and treatment ; Chemotherapy ; Cohort analysis ; Confidence intervals ; Endometrial cancer ; Endometrium ; Health aspects ; Lymphatic system ; Medical prognosis ; Metastases ; Metastasis ; Myometrium ; Oncology ; Oncology, Experimental ; Pathology ; Radiation therapy ; Regression analysis ; Risk factors ; Stroma ; Surgery ; Survival ; Survival analysis ; Tomography ; Tumors ; Vagina</subject><ispartof>Cancers, 2023-05, Vol.15 (9), p.2612</ispartof><rights>COPYRIGHT 2023 MDPI AG</rights><rights>2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). 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A Multicentre Retrospective Cohort Study of the Spain Gynecologic Oncology Group</title><title>Cancers</title><addtitle>Cancers (Basel)</addtitle><description>The main aim is to compare oncological outcomes and patterns of recurrence of patients with early-stage endometrioid endometrial cancer according to lymphovascular space invasion (LVSI) status. The secondary objective is to determine preoperative predictors of LVSI. We performed a multicenter retrospective cohort study. A total of 3546 women diagnosed with postoperative early-stage (FIGO I-II, 2009) endometrioid endometrial cancer were included. Co-primary endpoints were disease-free survival (DFS), overall survival (OS), and pattern of recurrence. Cox proportional hazard models were used for time-to-event analysis. Univariate and multivariate logistical regression models were employed. Positive LVSI was identified in 528 patients (14.6%) and was an independent prognostic factor for DFS (HR 1.8), OS (HR 2.1) and distant recurrences (HR 2.37). Distant recurrences were more frequent in patients with positive LVSI (78.2% vs. 61.3%,
< 0.01). Deep myometrial invasion (OR 3.04), high-grade tumors (OR 2.54), cervical stroma invasion (OR 2.01), and tumor diameter ≥ 2 cm (OR 2.03) were independent predictors of LVSI. In conclusion, in these patients, LVSI is an independent risk factor for shorter DFS and OS, and distant recurrence, but not for local recurrence. Deep myometrial invasion, cervical stroma invasion, high-grade tumors, and a tumor diameter ≥ 2 cm are independent predictors of LVSI.</description><subject>Cancer</subject><subject>Cancer therapies</subject><subject>Care and treatment</subject><subject>Chemotherapy</subject><subject>Cohort analysis</subject><subject>Confidence intervals</subject><subject>Endometrial cancer</subject><subject>Endometrium</subject><subject>Health aspects</subject><subject>Lymphatic system</subject><subject>Medical prognosis</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Myometrium</subject><subject>Oncology</subject><subject>Oncology, Experimental</subject><subject>Pathology</subject><subject>Radiation therapy</subject><subject>Regression analysis</subject><subject>Risk factors</subject><subject>Stroma</subject><subject>Surgery</subject><subject>Survival</subject><subject>Survival analysis</subject><subject>Tomography</subject><subject>Tumors</subject><subject>Vagina</subject><issn>2072-6694</issn><issn>2072-6694</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNptkk1v1DAQhiMEolXpmRuyxKU9ZOuPfHJBq2hZKi1qxcLZcpzJrqvEDrazUv4dPw1nW0pbYR88Gj_zzow9UfSe4AVjJb6SQkuwjqS4pBmhr6JTinMaZ1mZvH5in0Tnzt3hsBgjeZa_jU5YTvIEF-Q0-r2Z-mFvDsLJsRMWbQchAV3r4FBGI6XRSthuirde7ACtdGN68FaJDlXH7OhiM21X1eUndCu8B6sdMi36DnK0FgKAhG7QrYVGSW-sW6Al-jZ2XknQ3kIAvTVuAOnVAVBl9sZ6tPVjM80yfg9zQaGI9aRBms7slEQ3-mhNaG3NOLyL3rSic3D-cJ5FP7-sflRf483N-rpabmKZFKWP20Tgpi5qzJqaZDVlFNqClrhI0obKtkxlkhPapnVNGiLqJFAU03L2lhKoYGfR53vdYax7aI71i44PVvXCTtwIxZ_faLXnO3PgBJM8J0kRFC4eFKz5NYLzvFdOQtcJDWZ0nBaEpRlOGA3oxxfonRmtDv3NFGUFzYriH7UTHXClWxMSy1mUL_OkxGXGyKy1-A8VdgO9kkZDq4L_WcDVfYAMX-MstI9NEsznweMvBi9EfHj6No_83zFjfwDctNdU</recordid><startdate>20230504</startdate><enddate>20230504</enddate><creator>Oliver-Perez, M Reyes</creator><creator>Padilla-Iserte, Pablo</creator><creator>Arencibia-Sanchez, Octavio</creator><creator>Martin-Arriscado, Cristina</creator><creator>Muruzabal, Juan Carlos</creator><creator>Diaz-Feijóo, Berta</creator><creator>Cabrera, Silvia</creator><creator>Coronado, Pluvio</creator><creator>Martín-Salamanca, M Belen</creator><creator>Pantoja-Garrido, Manuel</creator><creator>Marcos-Sanmartin, Josefa</creator><creator>Cabezas-López, Elena</creator><creator>Lorenzo, Cristina</creator><creator>Beric, Duska</creator><creator>Rodriguez-Hernandez, Jose Ramon</creator><creator>Roldan-Rivas, Fernando</creator><creator>Gilabert-Estelles, Juan</creator><creator>Sanchez, Lourdes</creator><creator>Laseca-Modrego, Maria</creator><creator>Tauste-Rubio, Carmen</creator><creator>Gil-Ibañez, Blanca</creator><creator>Tejerizo-Garcia, Alvaro</creator><creator>On Behalf Of The Spain-Gog Group</creator><general>MDPI AG</general><general>MDPI</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7TO</scope><scope>7XB</scope><scope>8FE</scope><scope>8FH</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>HCIFZ</scope><scope>LK8</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-0207-8154</orcidid><orcidid>https://orcid.org/0000-0001-8711-4083</orcidid><orcidid>https://orcid.org/0000-0001-5907-8142</orcidid><orcidid>https://orcid.org/0000-0002-6451-1817</orcidid><orcidid>https://orcid.org/0000-0002-2147-2811</orcidid><orcidid>https://orcid.org/0000-0003-0357-2015</orcidid><orcidid>https://orcid.org/0000-0002-0777-3124</orcidid><orcidid>https://orcid.org/0000-0003-3563-1825</orcidid><orcidid>https://orcid.org/0000-0002-0361-8741</orcidid><orcidid>https://orcid.org/0000-0002-1943-1105</orcidid><orcidid>https://orcid.org/0000-0001-7352-8920</orcidid></search><sort><creationdate>20230504</creationdate><title>Lymphovascular Space Invasion in Early-Stage Endometrial Cancer (LySEC): Patterns of Recurrence and Predictors. A Multicentre Retrospective Cohort Study of the Spain Gynecologic Oncology Group</title><author>Oliver-Perez, M Reyes ; Padilla-Iserte, Pablo ; Arencibia-Sanchez, Octavio ; Martin-Arriscado, Cristina ; Muruzabal, Juan Carlos ; Diaz-Feijóo, Berta ; Cabrera, Silvia ; Coronado, Pluvio ; Martín-Salamanca, M Belen ; Pantoja-Garrido, Manuel ; Marcos-Sanmartin, Josefa ; Cabezas-López, Elena ; Lorenzo, Cristina ; Beric, Duska ; Rodriguez-Hernandez, Jose Ramon ; Roldan-Rivas, Fernando ; Gilabert-Estelles, Juan ; Sanchez, Lourdes ; Laseca-Modrego, Maria ; Tauste-Rubio, Carmen ; Gil-Ibañez, Blanca ; Tejerizo-Garcia, Alvaro ; On Behalf Of The Spain-Gog Group</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c489t-f4a0db8b03db16b232ef8290845d2cf95c4712f5bb1d1ab4db12029c4719ce2a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Cancer</topic><topic>Cancer therapies</topic><topic>Care and treatment</topic><topic>Chemotherapy</topic><topic>Cohort analysis</topic><topic>Confidence intervals</topic><topic>Endometrial cancer</topic><topic>Endometrium</topic><topic>Health aspects</topic><topic>Lymphatic system</topic><topic>Medical prognosis</topic><topic>Metastases</topic><topic>Metastasis</topic><topic>Myometrium</topic><topic>Oncology</topic><topic>Oncology, Experimental</topic><topic>Pathology</topic><topic>Radiation therapy</topic><topic>Regression analysis</topic><topic>Risk factors</topic><topic>Stroma</topic><topic>Surgery</topic><topic>Survival</topic><topic>Survival analysis</topic><topic>Tomography</topic><topic>Tumors</topic><topic>Vagina</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Oliver-Perez, M Reyes</creatorcontrib><creatorcontrib>Padilla-Iserte, Pablo</creatorcontrib><creatorcontrib>Arencibia-Sanchez, Octavio</creatorcontrib><creatorcontrib>Martin-Arriscado, Cristina</creatorcontrib><creatorcontrib>Muruzabal, Juan Carlos</creatorcontrib><creatorcontrib>Diaz-Feijóo, Berta</creatorcontrib><creatorcontrib>Cabrera, Silvia</creatorcontrib><creatorcontrib>Coronado, Pluvio</creatorcontrib><creatorcontrib>Martín-Salamanca, M Belen</creatorcontrib><creatorcontrib>Pantoja-Garrido, Manuel</creatorcontrib><creatorcontrib>Marcos-Sanmartin, Josefa</creatorcontrib><creatorcontrib>Cabezas-López, Elena</creatorcontrib><creatorcontrib>Lorenzo, Cristina</creatorcontrib><creatorcontrib>Beric, Duska</creatorcontrib><creatorcontrib>Rodriguez-Hernandez, Jose Ramon</creatorcontrib><creatorcontrib>Roldan-Rivas, Fernando</creatorcontrib><creatorcontrib>Gilabert-Estelles, Juan</creatorcontrib><creatorcontrib>Sanchez, Lourdes</creatorcontrib><creatorcontrib>Laseca-Modrego, Maria</creatorcontrib><creatorcontrib>Tauste-Rubio, Carmen</creatorcontrib><creatorcontrib>Gil-Ibañez, Blanca</creatorcontrib><creatorcontrib>Tejerizo-Garcia, Alvaro</creatorcontrib><creatorcontrib>On Behalf Of The Spain-Gog Group</creatorcontrib><creatorcontrib>on behalf of the Spain-GOG Group</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Research Library</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - 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A Multicentre Retrospective Cohort Study of the Spain Gynecologic Oncology Group</atitle><jtitle>Cancers</jtitle><addtitle>Cancers (Basel)</addtitle><date>2023-05-04</date><risdate>2023</risdate><volume>15</volume><issue>9</issue><spage>2612</spage><pages>2612-</pages><issn>2072-6694</issn><eissn>2072-6694</eissn><abstract>The main aim is to compare oncological outcomes and patterns of recurrence of patients with early-stage endometrioid endometrial cancer according to lymphovascular space invasion (LVSI) status. The secondary objective is to determine preoperative predictors of LVSI. We performed a multicenter retrospective cohort study. A total of 3546 women diagnosed with postoperative early-stage (FIGO I-II, 2009) endometrioid endometrial cancer were included. Co-primary endpoints were disease-free survival (DFS), overall survival (OS), and pattern of recurrence. Cox proportional hazard models were used for time-to-event analysis. Univariate and multivariate logistical regression models were employed. Positive LVSI was identified in 528 patients (14.6%) and was an independent prognostic factor for DFS (HR 1.8), OS (HR 2.1) and distant recurrences (HR 2.37). Distant recurrences were more frequent in patients with positive LVSI (78.2% vs. 61.3%,
< 0.01). Deep myometrial invasion (OR 3.04), high-grade tumors (OR 2.54), cervical stroma invasion (OR 2.01), and tumor diameter ≥ 2 cm (OR 2.03) were independent predictors of LVSI. In conclusion, in these patients, LVSI is an independent risk factor for shorter DFS and OS, and distant recurrence, but not for local recurrence. Deep myometrial invasion, cervical stroma invasion, high-grade tumors, and a tumor diameter ≥ 2 cm are independent predictors of LVSI.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>37174081</pmid><doi>10.3390/cancers15092612</doi><orcidid>https://orcid.org/0000-0003-0207-8154</orcidid><orcidid>https://orcid.org/0000-0001-8711-4083</orcidid><orcidid>https://orcid.org/0000-0001-5907-8142</orcidid><orcidid>https://orcid.org/0000-0002-6451-1817</orcidid><orcidid>https://orcid.org/0000-0002-2147-2811</orcidid><orcidid>https://orcid.org/0000-0003-0357-2015</orcidid><orcidid>https://orcid.org/0000-0002-0777-3124</orcidid><orcidid>https://orcid.org/0000-0003-3563-1825</orcidid><orcidid>https://orcid.org/0000-0002-0361-8741</orcidid><orcidid>https://orcid.org/0000-0002-1943-1105</orcidid><orcidid>https://orcid.org/0000-0001-7352-8920</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2072-6694 |
| ispartof | Cancers, 2023-05, Vol.15 (9), p.2612 |
| issn | 2072-6694 2072-6694 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10177148 |
| source | Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central Open Access; MDPI - Multidisciplinary Digital Publishing Institute; PubMed Central |
| subjects | Cancer Cancer therapies Care and treatment Chemotherapy Cohort analysis Confidence intervals Endometrial cancer Endometrium Health aspects Lymphatic system Medical prognosis Metastases Metastasis Myometrium Oncology Oncology, Experimental Pathology Radiation therapy Regression analysis Risk factors Stroma Surgery Survival Survival analysis Tomography Tumors Vagina |
| title | Lymphovascular Space Invasion in Early-Stage Endometrial Cancer (LySEC): Patterns of Recurrence and Predictors. A Multicentre Retrospective Cohort Study of the Spain Gynecologic Oncology Group |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-23T23%3A34%3A07IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Lymphovascular%20Space%20Invasion%20in%20Early-Stage%20Endometrial%20Cancer%20(LySEC):%20Patterns%20of%20Recurrence%20and%20Predictors.%20A%20Multicentre%20Retrospective%20Cohort%20Study%20of%20the%20Spain%20Gynecologic%20Oncology%20Group&rft.jtitle=Cancers&rft.au=Oliver-Perez,%20M%20Reyes&rft.aucorp=on%20behalf%20of%20the%20Spain-GOG%20Group&rft.date=2023-05-04&rft.volume=15&rft.issue=9&rft.spage=2612&rft.pages=2612-&rft.issn=2072-6694&rft.eissn=2072-6694&rft_id=info:doi/10.3390/cancers15092612&rft_dat=%3Cgale_pubme%3EA749096312%3C/gale_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2812382688&rft_id=info:pmid/37174081&rft_galeid=A749096312&rfr_iscdi=true |