Significance of lymphovascular space invasion in epithelial ovarian cancer

Cancer Medicine

Koji Matsuo³  Todd B. Sheridan⁵  Kiyoshi Yoshino¹  Takahito Miyake¹  Karina E. Hew²  Dwight D. Im²  Neil B. Rosenshein²  Seiji Mabuchi¹  Takayuki Enomoto¹  Tadashi Kimura¹  Anil K. Sood⁴ 

[1] Department of Obstetrics and Gynecology, Osaka University Faculty of Medicine, Suita, Osaka, Japan;Gynecologic Oncology Center, Mercy Medical Center, Baltimore, MD;Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Los Angeles County Medical Center, University of Southern California, Los Angeles, CA;Department of Gynecologic Oncology, MD Anderson Cancer Center, University of Texas, Houston, TX;Department of Pathology, Mercy Medical Center, Baltimore, MD

关键词: Lymph node metastasis;    lymphovascular space invasion;    ovarian cancer;    survival;   

DOI  :  10.1002/cam4.31

来源: Wiley

【 摘 要 】

Abstract

While the prognostic significance of lymphovascular space invasion (LVSI) is well established in endometrial and cervical cancer, its role in ovarian cancer is not fully understood. First, a training cohort was conducted to explore whether the presence and quantity of LVSI within the ovarian tumor correlated with nodal metastasis and survival (n = 127). Next, the results of the training cohort were applied to a different study population (validation cohort, n = 93). In both cohorts, histopathology slides of epithelial ovarian cancer cases that underwent primary cytoreductive surgery including pelvic and/or aortic lymphadenectomy were examined. In a post hoc analysis, the significance of LVSI was evaluated in apparent stage I cases (n = 53). In the training cohort, the majority of patients had advanced-stage disease (82.7%). LVSI was observed in 79.5% of cases, and nodal metastasis was the strongest variable associated with the presence of LVSI (odds ratio [OR]: 7.99, 95% confidence interval [CI]: 1.98–32.1, P = 0.003) in multivariate analysis. The presence of LVSI correlated with a worsened progression-free survival on multivariate analysis (hazard ratio [HR]: 2.06, 95% CI: 1.01–4.24, P = 0.048). The significance of the presence of LVSI was reproduced in the validation cohort (majority, early stage 61.3%). In apparent stage I cases, the presence of LVSI was associated with a high negative predictive value for nodal metastasis (100%, likelihood ratio, P = 0.034) and with worsened progression-free survival (HR: 5.16, 95% CI: 1.00–26.6, P = 0.028). The presence of LVSI is an independent predictive indicator of nodal metastasis and is associated with worse clinical outcome of patients with epithelial ovarian cancer.

【 授权许可】

CC BY   
© 2012 The Authors. Cancer Medicine published by Blackwell Publishing Ltd.

Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.