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

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• 作者：Suk-Joon Chang MD ; PhD (1)
  Tae Wook Kong MD (1)
  Woo Young Kim MD (1)
  Seung-Chul Yoo MD ; PhD (1)
  Jong-Hyuck Yoon MD (1)
  Ki-Hong Chang MD ; PhD (1)
  Hee-Sug Ryu MD ; PhD (1)
  
• 刊名：Annals of Surgical Oncology
• 出版年：2011
• 出版时间：January 2011
• 年：2011
• 卷：18
• 期：1
• 页码：58-64
• 全文大小：181KB
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• 作者单位：Suk-Joon Chang MD, PhD (1)
  Tae Wook Kong MD (1)
  Woo Young Kim MD (1)
  Seung-Chul Yoo MD, PhD (1)
  Jong-Hyuck Yoon MD (1)
  Ki-Hong Chang MD, PhD (1)
  Hee-Sug Ryu MD, PhD (1)
  
  1. Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Korea
  

文摘

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.