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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.

Authors
Chang, SJ; Kong, TW; Kim, WY; Yoo, SC; Yoon, JH; Chang, KH; Ryu, HS
Citation
Annals of surgical oncology, 18(1):58-64, 2011
Journal Title
Annals of surgical oncology
ISSN
1068-92651534-4681
Abstract
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.
MeSH terms
AdultAgedAged, 80 and overCarcinoma, Papillary/*secondary/surgeryCarcinosarcoma/*secondary/surgeryCystadenocarcinoma, Serous/*secondary/surgeryEndometrial Neoplasms/*pathology/surgeryFemaleFollow-Up StudiesHumansLymph Nodes/*pathology/surgeryLymphatic MetastasisLymphatic Vessels/*pathology/surgeryMiddle AgedNeoplasm InvasivenessPeritoneal Neoplasms/*secondary/surgeryRetrospective StudiesRisk FactorsSurvival RateTreatment Outcome
DOI
10.1245/s10434-010-1206-x
PMID
20607418
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Obstetrics & Gynecology
Journal Papers > School of Medicine / Graduate School of Medicine > Medical Science
AJOU Authors
장, 석준김, 우영유, 승철윤, 종혁장, 기홍유, 희석
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