Lymphovascular space invasion and positive pelvic lymph nodes are independent risk factors for para-aortic nodal metastasis in endometrioid endometrial cancer

2015 ◽  
Vol 186 ◽  
pp. 63-67 ◽  
Author(s):  
Ulas Solmaz ◽  
Emre Mat ◽  
Murat Levent Dereli ◽  
Volkan Turan ◽  
Gokhan Tosun ◽  
...  
Keyword(s):  
Risk Factors ◽  
Endometrial Cancer ◽  
Lymph Nodes ◽  
Nodal Metastasis ◽  
Pelvic Lymph Nodes ◽  
Endometrioid Endometrial Cancer ◽  
Independent Risk Factors ◽  
Lymphovascular Space Invasion

Ultrastaging of ‘negative’ pelvic lymph nodes in patients with low- and intermediate-risk endometrioid endometrial cancer who developed non-vaginal recurrences

2021 ◽  
pp. ijgc-2021-002924
Author(s):  
Sarah E Gill ◽  
Simone Garzon ◽  
Francesco Multinu ◽  
Alexis N Hokenstad ◽  
Jvan Casarin ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Myometrial Invasion ◽  
Figo Stage ◽  
Peritoneal Cytology ◽  
Intermediate Risk ◽  
Pelvic Lymph Nodes ◽  
Vaginal Recurrence ◽  
Lymphovascular Space Invasion

ObjectiveEvidence on micrometastases and isolated tumor cells as factors associated with non-vaginal recurrence in low- and intermediate-risk endometrial cancer is limited. The goal of our study was to investigate risk factors for non-vaginal recurrence in low- and intermediate-risk endometrial cancer.MethodsRecords of all patients with endometrial cancer surgically managed at the Mayo Clinic before sentinel lymph node implementation (1999–2008) were reviewed. We identified all patients with endometrioid low-risk (International Federation of Gynecology and Obstetrics (FIGO) stage I, grade 1 or 2 with myometrial invasion <50% and negative peritoneal cytology) or intermediate-risk (FIGO stage I, grade 1 or 2 with myometrial invasion ≥50% or grade 3 with myometrial invasion <50% and negative peritoneal cytology) endometrial cancer at definitive pathology after pelvic and para-aortic lymph node assessment. All pelvic lymph nodes of patients with non-vaginal recurrence (any recurrence excluding isolated vaginal cuff recurrences) underwent ultrastaging.ResultsAmong 1303 women, we identified 321 patients with low-risk (n=236) or intermediate-risk (n=85) endometrial cancer (median age 65.4 years; 266 (82.9%) stage IA; 55 (17.1%) stage IB). Of the total of 321, 13 patients developed non-vaginal recurrence (Kaplan–Meier rate 4.7% by 60 months; 95% CI 2.1% to 7.2%): 11 hematogenous/peritoneal and two para-aortic and distant lymphatic. Myometrial invasion and lymphovascular space invasion were univariately associated with non-vaginal recurrence. In these patients, the original hematoxylin/eosin slides review confirmed all 646 pelvic and para-aortic removed lymph nodes as negative. The ultrastaging of 463 pelvic lymph nodes did not identify any occult metastases (prevalence 0%; 95% CI 0% to 22.8% considering 13 patients; 95% CI 0% to 0.8% considering 463 pelvic lymph nodes).ConclusionThere were no occult metastases in pelvic lymph nodes of patients with low- or intermediate-risk endometrial cancer with non-vaginal recurrence. Myometrial invasion and lymphovascular space invasion appear to be associated with non-vaginal recurrence.

Lymphovascular Space Invasion and the Treatment of Stage I Endometrioid Endometrial Cancer

2015 ◽  
Vol 25 (1) ◽  
pp. 75-80 ◽  
Author(s):  
Louis J.M. van der Putten ◽  
Yvette P. Geels ◽  
Nicole P.M. Ezendam ◽  
Hans W.H.M. van der Putten ◽  
Marc P.M.L. Snijders ◽  
...  
Keyword(s):  
Risk Factors ◽  
Endometrial Cancer ◽  
Adjuvant Radiotherapy ◽  
Early Stage ◽  
Myometrial Invasion ◽  
Distant Recurrence ◽  
Stage I ◽  
Recurrence Rates ◽  
Endometrioid Endometrial Cancer ◽  
Lymphovascular Space Invasion

ObjectivesTreatment of clinical early-stage endometrioid endometrial cancer (EEC) in The Netherlands consists of primary hysterectomy and bilateral salpingo-oophorectomy. Adjuvant radiotherapy is given when 2 or more the following risk factors are present: 60 years or older, grade 3 histology, and 50% or more myometrial invasion. Lymphovascular space invasion (LVSI) is a predictor of poor prognosis and early distant spread. It is unclear whether adjuvant radiotherapy is sufficient in patients with LVSI-positive EEC.Methods/MaterialsEighty-one patients treated from 1999 until 2011 for stage I LVSI-positive EEC in 11 Dutch hospitals were included. The outcomes of patients with 0 to 1 risk factors were compared with those with 2 to 3 risk factors, and both were compared with the known literature.ResultsEighteen patients presented with recurrent disease, and 12 of those recurrences had a distant component. Overall and distant recurrence rates were 19.2% and 11.5% in patients with 0 to 1 risk factors followed by observation and 25.5% and 17% in patients with 2 to 3 risk factors who received adjuvant radiotherapy. Only 1 patient with grade 1 disease had a recurrence.ConclusionsIn stage I LVSI-positive EEC with 0 to 1 risk factors, observation might not be adequate. Moreover, despite adjuvant radiotherapy, a high overall and distant recurrence rate was observed in patients with 2 to 3 risk factors. The use of systemic treatment in these patients, with the exception of patients with grade 1 disease, should be investigated.

The incidence of isolated paraaortic nodal metastasis in surgically staged endometrial cancer patients with negative pelvic lymph nodes

2009 ◽  
Vol 115 (2) ◽  
pp. 236-238 ◽  
Author(s):  
Nadeem R. Abu-Rustum ◽  
Jacob D. Gomez ◽  
Kaled M. Alektiar ◽  
Robert A. Soslow ◽  
Martee L. Hensley ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Nodal Metastasis ◽  
Pelvic Lymph Nodes

scholarly journals Pathological features of lymph nodes around inferior mesenteric artery in rectal cancer: a retrospective study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Chunhui Jiang ◽  
Ye Liu ◽  
Chunjie Xu ◽  
Yanying Shen ◽  
Qing Xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rectal Cancer ◽  
Lymph Nodes ◽  
Mesenteric Artery ◽  
Inferior Mesenteric Artery ◽  
Anal Verge ◽  
T Stage ◽  
Pathological Type ◽  
Nerve Invasion ◽  
Independent Risk Factors

Abstract Objective This study aimed to explore the pathological characteristics of lymph nodes around inferior mesenteric artery in rectal cancer and its risk factors and its impact on tumor staging. Methods 485 rectal cancer patients underwent proctectomy surgery were collected in this study. Clinical features of patients, including gender, age, BMI, tumor size, pathological type, differentiation, nerve invasion, lymph nodes, tumor marker, and pathological examinations, were analyzed. Results A total of 485 cases were included in this study. There were 29 cases with IMA-LN metastasis; the metastasis rate was 5.98% (29/485). Positive IMA-LNs were associated with distance from anal verge, CEA, pathological type, differentiation, nerve invasion, T stage, and N stage. Multivariate analysis showed that distance from anal verge, CEA level, differentiation, and T stage were independent risk factors for positive IMA-LNs. Conclusion Distance from anal verge, CEA level, differentiation, and T stage were independent risk factors for positive IMA-LNs. No skip metastasis occurred in IMA-LNs. We should choose the appropriate surgical methods to achieve better oncological results and reduce the incidence of postoperative complications.

scholarly journals 119 The positive pelvic lymph nodes in endometrial cancer – histopathological parameters as predictors

2020 ◽  
Author(s):  
Aljosa Mandic ◽  
Dunja Kokanov ◽  
Bojana Gutic ◽  
Tatjana Ivkovic Kapicl ◽  
Slobodan Maricic ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Lymph Nodes ◽  
Pelvic Lymph Nodes

scholarly journals Clinicopathological Characteristics and Prognosis in Endometrial Cancer With Bone Metastasis: A SEER-Based Study of 584 Women

2021 ◽  
Vol 11 ◽  
Author(s):  
Hejia Hu ◽  
Zhan Wang ◽  
Miaofeng Zhang ◽  
Feng Niu ◽  
Qunfei Yu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Endometrial Cancer ◽  
Bone Metastasis ◽  
Brain Metastases ◽  
Systemic Chemotherapy ◽  
Tumor Grade ◽  
Seer Database ◽  
Tumor Subtype ◽  
Local Surgery ◽  
Independent Risk Factors

PurposeBone metastasis from endometrial cancer (EC) is rare and poorly described. The purpose of the present study was to investigate the correlation between the clinically accessible factors and survival time among EC patients with bone metastasis.Patients and MethodsWe retrospectively identified and reviewed EC patients with bone metastasis from 2010 to 2016, based on the Surveillance, Epidemiology and End Results (SEER) database. Univariable and multivariable Cox regressions were applied to evaluate the effects of clinical variables on survival. Kaplan–Meier plots were used to visually demonstrate the correlation between independent risk factors and survival.ResultsClinical data of 584 EC patients with bone metastasis from the SEER database were analyzed. EC patients with bone metastasis experienced extremely poor survival, with 1-year overall survival (OS) and cancer-specific survival (CSS) rates 33.8 and 35.8%, respectively. Variables associated with OS and CSS in the univariable analysis included race, tumor grade, tumor subtype, tumor size, lung, liver and brain metastases, surgery, radiotherapy, and chemotherapy. In the multivariable analysis, tumor grade, tumor subtype, liver and brain metastases, local surgery, and systemic chemotherapy remained independent risk factors for OS and CSS. However, local radiotherapy was an independent predictor of OS, not CSS.ConclusionsWe identified several factors affect the survival of EC patients with bone metastasis, which is useful for clinicians to assess patients’ outcomes. Our study supports surgery and radiotherapy of primary EC, and systemic chemotherapy for prolonging survival among EC patients with bone metastasis, which lays a solid foundation for defining optimal treatment strategy in this specific cohort.

Prevalence, Classification, and Risk Factors for Postoperative Lower Extremity Lymphedema in Women With Gynecologic Malignancies: A Retrospective Study

2015 ◽  
Vol 25 (4) ◽  
pp. 751-757 ◽  
Author(s):  
Hitoshi Hareyama ◽  
Kenichi Hada ◽  
Kumiko Goto ◽  
Sawako Watanabe ◽  
Minako Hakoyama ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lower Extremity ◽  
Lymph Nodes ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Cancer Type ◽  
Kaplan Meier ◽  
Gynecology And Obstetrics ◽  
Independent Risk Factors ◽  
Stage 1

ObjectiveLower extremity lymphedema (LEL) is a major long-term complication of radical surgery. We aimed to estimate the incidence and grading of LEL in women who underwent lymphadenectomy and to evaluate risk factors associated with LEL.Materials and MethodsWe retrospectively reviewed 358 patients with cervical, endometrial, and ovarian cancer who underwent transabdominal complete systematic pelvic and para-aortic lymphadenectomy between 1997 and 2011. Lower extremity lymphedema was graded according to criteria of the International Society of Lymphology. Incidence of LEL and its correlation with various clinical characteristics were investigated using Kaplan-Meier survival and Cox proportional hazards methods.ResultsOverall incidence of LEL was 21.8% (stage 1, 60%; stage 2, 32%; and stage 3, 8%). Cumulative incidence increased with observation period: 12.9% at 1 year, 20.3% at 5 years, and 25.4% at 10 years. Age, cancer type, stage (International Federation of Gynecology and Obstetrics), body mass index, hysterectomy type, lymphocyst formation, lymph node metastasis, and chemotherapy were not associated with LEL. Multivariate analysis confirmed that removal of circumflex iliac lymph nodes (hazard ratio [HR], 4.28; 95% confidence interval [CI], 2.09–8.77; P < 0.0001), cellulitis (HR, 3.48; 95% CI, 2.03–5.98; P < 0.0001), and number of removed lymph nodes (HR, 0.99; 95% CI, 0.98–0.99; P = 0.038) were independent risk factors for LEL.ConclusionsPostoperative LEL incidence increased over time. The results of the present study showed a significant correlation with removal of circumflex iliac lymph nodes and cellulitis with the incidence of LEL. Multicenter or prospective studies are required to clarify treatment efficacies.

scholarly journals Risk Factors and Prognostic Significance of Retropancreatic Lymph Nodes in Gastric Adenocarcinoma

2015 ◽  
Vol 2015 ◽  
pp. 1-7
Author(s):  
Lian Xue ◽  
Xiao-Long Chen ◽  
Wei-Han Zhang ◽  
Kun Yang ◽  
Xin-Zu Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lymph Nodes ◽  
Gastric Adenocarcinoma ◽  
Prognostic Significance ◽  
Metastatic Rate ◽  
Kaplan Meier ◽  
Independent Risk Factors ◽  
Pn Stage ◽  
Lymph Nodes Dissection ◽  
Worse Prognosis

Background. The studies on risk factors and metastatic rate of retropancreatic (number 13) lymph nodes in gastric adenocarcinoma were few and the results were still controversial. The aim of this study was to elucidate risk factors and prognostic significance of number 13 lymph nodes in gastric adenocarcinoma.Method. From January 2000 to December 2011, 114 patients who underwent gastrectomy with number 13 lymph nodes dissection were enrolled and followed up to January 2014. Patients were grouped according to whether number 13 lymph nodes were positive or negative.Results. The metastatic rate of number 13 lymph nodes was 22.8%. In multivariate analysis, pT stage (P=0.027), pN stage (P=0.005), and number 11p (P=0.015) lymph nodes were independent risk factors of positive number 13 lymph nodes. In all patients (P<0.001) and subpopulation with TNM III stage (P=0.007), positive number 13 lymph nodes had significantly worse prognosis than those of patients with negative number 13 LNs in Kaplan-Meier analysis.Conclusion. Number 13 lymph nodes had relatively high metastatic rate and led to poor prognosis. pT stage, pN stage, and number 11p lymph nodes were independent risk factors of positive number 13 lymph nodes.

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