Substantial Lymphovascular Space Invasion Is an Adverse Prognostic Factor in High-risk Endometrial Cancer

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Elke E.M. Peters ◽  
Alicia Léon-Castillo ◽  
Estrid Hogdall ◽  
Marie Boennelycke ◽  
Vincent T.H.B.M. Smit ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
High Risk ◽  
Prognostic Factor ◽  
Adverse Prognostic Factor ◽  
Lymphovascular Space Invasion

Blood Vessel Invasion Is a Strong Predictor of Postoperative Recurrence in Endometrial Cancer

2018 ◽  
Vol 28 (5) ◽  
pp. 875-881 ◽  
Author(s):  
Marie Sato ◽  
Ayumi Taguchi ◽  
Yamato Fukui ◽  
Akira Kawata ◽  
Satoru Taguchi ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Prognostic Factor ◽  
Blood Vessel ◽  
Strong Predictor ◽  
Postoperative Recurrence ◽  
Blood Vessel Invasion ◽  
Free Survival ◽  
Vessel Invasion ◽  
Patterns Of Recurrence ◽  
Lymphovascular Space Invasion

ObjectivesAlthough lymphovascular space invasion is a prognostic factor for the recurrence of resectable endometrial cancer, the differential impacts of lymphatic vessel invasion (LVI) and blood vessel invasion (BVI) on the recurrence of endometrial cancer are poorly described. We investigated the prognostic significance of LVI and BVI on the recurrence of endometrial cancer and their association with patterns of recurrence.MethodsWe retrospectively reviewed 376 patients with stage I to III endometrial cancer who underwent surgery with curative intent at our institution between 2007 and 2015. The associations of the presence of lymphovascular space invasion or LVI and BVI with recurrence-free survival and patterns of recurrence were evaluated.ResultsLymphovascular space invasion positivity was an independent prognostic factor for recurrence-free survival (hazards ratio [HR], 3.070; 95% confidence interval [CI], 1.404–6.824; P = 0.0048). However, when categorized by LVI versus BVI, the latter was a strong independent prognostic factor (HR, 2.697; CI, 1.288–5.798; P = 0.0081), whereas the former was not (HR, 1.740; CI, 0.795–3.721; P = 0.1637). Hematogenous metastasis was the most prevalent form of recurrence in endometrial cancer (24 [50%] of all 48 recurrent cases). Notably, 17 (19.5%) of 87 patients with BVI developed hematogenous metastases, compared with 7 (2.4%) of 289 without BVI (χ2 test, P < 0.0001).ConclusionsBlood vessel invasion rather than LVI was a strong predictor of postoperative recurrence in stage I to III endometrial cancer, probably due to its predisposition to hematogenous metastases.

scholarly journals Honing the classification of high-risk endometrial cancer with inclusion of lymphovascular space invasion

2017 ◽  
Vol 26 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Sofiane Bendifallah ◽  
Morgane Perrin ◽  
Lobna Ouldamer ◽  
Vincent Lavoué ◽  
Geoffroy Canlorbe ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
High Risk ◽  
Lymphovascular Space Invasion

High Serum Vascular Endothelial Growth Factor (VEGF) Level Is An Adverse Prognostic Factor In High Risk Diffuse Large B-Cell Lymphoma (DLBCL) Patients Treated with Dose-Dense Chemoimmunotherapy and Systemic CNS Prophylaxis. Results From a Nordic Phase II Study

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4142-4142
Author(s):  
Sari Riihijarvi ◽  
Heidi Nyman ◽  
Harald Holte ◽  
Magnus Bjorkholm ◽  
Oystein Fluge ◽  
...  
Keyword(s):  
Gene Expression ◽  
High Risk ◽  
Prognostic Factor ◽  
Phase Ii ◽  
High Dose ◽  
Vegf Gene ◽  
Adverse Prognostic Factor ◽  
Cns Prophylaxis ◽  
Grade 3 ◽  
Vegf Level

Abstract Abstract 4142 Background: VEGF is one of the most specific and critical regulators of angiogenesis. It regulates normal endothelial proliferation, permeability, and survival, but is also an angiogenic mediator in tumours, and has been implicated in the pathogenesis and progression of cancer. Elevated serum VEGF (S-VEGF) levels have been associated with unfavourable outcome in different hematologic malignancies including DLBCL. However, to our knowledge there is no data about the prognostic relevance of S-VEGF levels in the rituximab era. The aim of this study was to determine if pretreatment S-VEGF levels and VEGF gene expression in the DLBCL tissue correlate with survival of patients treated with chemoimmunotherapy. Patients and methods: Study population consisted of DLBCL and follicular lymphoma (FL) grade 3 patients, who were less than 65 years old and had high-risk (aaIPI 2–3) disease. All patients were treated in the Nordic phase II protocol with six courses of R-CHOEP14 followed by systemic CNS prophylaxis with one course of high-dose methotrexate and one course of high-dose cytarabine. Pretreatment serum was available for VEGF Enzyme-Linked Immuno-Sorbent Assay (ELISA) from 112 trial patients. VEGF gene expression could be analyzed from the exon-based microarrays of 41 pretreatment biopsies. In the present report of the 112 patients with a median follow-up of 37 months, (range 17–64 months), 3-year relapse free survival (RFS) was 76% and overall survival (OS) 82%. Results: S-VEGF levels at diagnosis varied from undetectable to 2000 pg/ml, median concentration being 530 pg/ml. 10 patients had values higher than the highest standard, 2000 pg/ml. 28 patients (25%) had S-VEGF level higher than 925 pg/ml (highest quartile). According to Kaplan-Meier analyses, RFS at 3 years was poorer among the patients with high (the highest quartile) than low S-VEGF-levels (59% vs 82%, p=0.005) The risk of relapse was 2.9 fold among the patients with high S-VEGF level (95% CI 1.34–6.26, p=0.007). In contrast to serum data, VEGF gene expression in the lymphoma tissue of the same patients did not associate with outcome. Furthermore, no correlation between S-VEGF levels and VEGF gene expression was found. To validate the gene expression results we used microarray data from an independent set of 233 DLBCL patients treated with a combination of rituximab and CHOP-like chemotherapy (Lenz et al., 2008). Again, no correlation with VEGF gene expression and outcome could be observed. Conclusions: High pretreatment S-VEGF level is an adverse prognostic factor for young high-risk DLBCL/FL grade 3 patients treated with chemoimmunotherapy, whereas VEGF gene expression in the lymphoma tissue correlates neither with the S-VEGF levels nor the prognosis. The results suggest that S-VEGF does not necessarily arise from the lymphoma tissue but may instead reflect host response to lymphoma. Disclosures: No relevant conflicts of interest to declare.

Prognostic Significance of Lymphovascular Space Invasion in the Absence of Lymph Node Metastases in Early-Stage Endometrial Cancer

2018 ◽  
Vol 28 (5) ◽  
pp. 890-894 ◽  
Author(s):  
Ellen Cusano ◽  
Victoria Myers ◽  
Rajiv Samant ◽  
Talia Sudai ◽  
Allison Keller ◽  
...  
Keyword(s):  
Overall Survival ◽  
Endometrial Cancer ◽  
Prognostic Factor ◽  
Early Stage ◽  
Prognostic Significance ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Node Negative ◽  
Early Stage Endometrial Cancer ◽  
Lymphovascular Space Invasion

ObjectiveLymphovascular space invasion (LVSI) has been defined as a significant adverse prognostic factor in early-stage endometrial cancer, primarily because of its high association with nodal metastases. This study aimed to determine if LVSI provides any prognostic significance in pathologic node-negative surgically staged (T1N0) endometrial cancer patients.Methods/MaterialsThis retrospective cohort study included all patients with pathologic stage T1N0 endometrial carcinoma treated at The Ottawa Hospital Cancer Centre from 1998 to 2007. Patient demographics, pathologic findings, treatment, and outcome data were collected. Univariate and multivariate cox regression modeling was used to assess significance and adjust for demographic and histopathologic covariates. Kaplan-Meier curves were used to estimate the 5-year overall and recurrence-free survival.ResultsOur study included 400 pathologic stage T1N0 patients who received an initial total hysterectomy and bilateral salpingo-oophorectomy with lymphadenectomy. The median age at diagnosis was 62 years, and the median follow-up was 66 months. Fifty-four patients (13.5%) had a positive LVSI status, and 346 (86.5%) had a negative LVSI status. The 5-year overall survival was 97.3% in patients without LVSI and 90.9% in those with LVSI (P < 0.001). The 5-year recurrence-free survival was 95.2% in patients without LVSI and 85.9% in those with LVSI (P = 0.006). Univariate analysis identified grade, stage, and LVSI as the covariates significantly associated with time to recurrence, and identified age, grade, stage, and LVSI to be significantly associated with overall survival. There were no significant covariates for recurrence-free survival by multivariate analysis, and only age and LVSI were significant for overall survival.ConclusionsLymphovascular space invasion is an overall poor prognostic factor in T1N0 endometrial cancer. After adjusting for other factors, LVSI remains an independent risk factor for worse overall survival. Therefore, estimation of overall survival in patients with early-stage, node-negative endometrial cancer should take into account LVSI status.

Progression in Smoldering Myeloma Is Independently Determined by the Chromosomal Abnormalities del(17p), t(4;14), Gain 1q, Hyperdiploidy, and Tumor Load

2013 ◽  
Vol 31 (34) ◽  
pp. 4325-4332 ◽  
Author(s):  
Kai Neben ◽  
Anna Jauch ◽  
Thomas Hielscher ◽  
Jens Hillengass ◽  
Nicola Lehners ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
High Risk ◽  
Prognostic Factor ◽  
Chromosomal Aberrations ◽  
Chromosomal Abnormalities ◽  
Intrinsic Property ◽  
Consecutive Series ◽  
Myeloma Cells ◽  
Adverse Prognostic Factor ◽  
Tumor Load

Purpose The aim of this study was to analyze chromosomal aberrations in terms of frequency and impact on time to progression in patients with smoldering multiple myeloma (SMM) on the background of clinical prognostic factors. Patients and Methods The chromosomal abnormalities 1q21, 5p15/5q35, 9q34, 13q14.3, 15q22, 17p13, t(11;14)(q13;q32), and t(4;14)(p16.3;q32) were assessed in CD138-purified myeloma cells by interphase fluorescent in situ hybridization (iFISH) alongside clinical parameters in a consecutive series of 248 patients with SMM. Results The high-risk aberrations in active myeloma (ie, del(17p13), t(4;14), and +1q21) present in 6.1%, 8.9%, and 29.8% of patients significantly confer adverse prognosis in SMM with hazard ratios (HRs) of 2.90 (95% CI, 1.56 to 5.40), 2.28 (95% CI, 1.33 to 3.91), and 1.66 (95% CI, 1.08 to 2.54), respectively. Contrary to the conditions in active myeloma, hyperdiploidy, present in 43.3% of patients, is an adverse prognostic factor (HR, 1.67; 95% CI, 1.10 to 2.54). Percentage of malignant bone marrow plasma cells assessed by iFISH and combination of M-protein and plasma cell infiltration as surrogates of tumor load significantly confer adverse prognosis with HRs of 4.37 (95% CI, 2.79 to 6.85) and 4.27 (95% CI, 2.77 to 6.56), respectively. In multivariate analysis, high-risk aberrations, hyperdiploidy, and surrogates of tumor load are independently prognostic. Conclusion The high-risk chromosomal aberrations del(17p13), t(4;14), and +1q21 are adverse prognostic factors in SMM just as they are in active myeloma, independent of tumor mass. Hyperdiploidy is the first example for an adverse prognostic factor in SMM of opposite predictiveness in active myeloma. Risk association of chromosomal aberrations is not only a priori treatment dependent (predictive) but is also an intrinsic property of myeloma cells (prognostic).

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