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Factors predicting recurrence in patients with stage IA endometrioid endometrial cancer: what is the importance of LVSI?

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study is to define the clinical and pathological prognostic factors for recurrence and to evaluate the recurrence patterns and adjuvant therapies used in this group of patients with stage IA endometrioid type endometrial cancer (FIGO 2009—International Federation of Gynecology and Obstetrics).

Methods

Among the patients with epithelial endometrial cancer operated between January 1993 and May 2013 in a single institution, 720 patients with stage IA endometrioid endometrial cancer were included. Patients with a tumor type of serous, clear cell, mucinous, undifferentiated, and mixed type and with a tumor containing sarcomatous component and the patients with a secondary primer cancer were excluded from the study.

Results

Lympho-vascular space invasion (LVSI) was present in 60 (8.3%) patients. Pelvic and para-aortic lymphadenectomy was performed in 266 (36.9%) patients. Median follow-up time was 48 months (range 3–240). Recurrence occurred in 23 (3.4%) patients and 6 (0.9%) died of disease. The median time-to recurrence (TTR) was 24 months (range 4–52 months) in the patients with recurrence. LVSI was associated with recurrence in the univariate analysis. Five-year disease-free survival (DFS) decreased from 96.8 to 80.1% in the presence of LVSI (p < 0.001). This association could not be shown in patients who had had lymphadenectomy (p = 0.136). Extra-pelvic recurrence occurred in 6.7% and 1% of the patients with and without LVSI, respectively, (p = 0.001). Any independent prognostic factor could not be detected in the multivariate analysis.

Conclusions

Only LVSI and tumor grade were associated with DFS and disease-specific survival (DSS), respectively, in the 686 patients with stage IA endometrial cancer in the univariate analysis, since these associations could not be shown in multivariate analysis.

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Authors and Affiliations

  1. Department of Gynecological Oncology, Antalya Training and Research Hospital, Muratpasa, 07030, Antalya, Turkey

    Isin Ureyen

  2. Department of Gynecological Oncology, Etlik Zubeyde Hanim Women’s Health Training and Research Hospital, Ankara, Turkey

    Alper Karalok, Osman Turkmen, Gunsu Kimyon, Yildiz Reis Akdas, Aysegul Akyol, Tolga Tasci & Taner Turan

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  1. Isin Ureyen
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  2. Alper Karalok
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  6. Aysegul Akyol
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Contributions

IU: project development, manuscript writing. AK: project development, manuscript writing. OT: data analysis. GK: data analysis. YRA: data collection. AA: data collection. TT: manuscript writing. TT: project development.

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Correspondence to Isin Ureyen.

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The authors declared no conflicts of interest.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the institutional and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was not obtained from participants included in the study, since the study was retrospective.

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Ureyen, I., Karalok, A., Turkmen, O. et al. Factors predicting recurrence in patients with stage IA endometrioid endometrial cancer: what is the importance of LVSI?. Arch Gynecol Obstet 301, 737–744 (2020). https://doi.org/10.1007/s00404-019-05418-z

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