EP1255 The effect of lymph vessel invasion on the survival rate in low-risk endometrial cancer

Endometrial cancer is one of the most common malignant tumors, lowering the quality of life among women worldwide. Autophagy plays dual roles in these malignancies. To search for prognostic markers for endometrial cancer, we mined The Cancer Genome Atlas and the Human Autophagy Database for information on endometrial cancer and autophagy-related genes and identified five autophagy-related long noncoding RNAs (lncRNAs) (LINC01871, SCARNA9, SOS1-IT1, AL161618.1, and FIRRE). Based on these autophagy-related lncRNAs, samples were divided into high-risk and low-risk groups. Survival analysis showed that the survival rate of the high-risk group was significantly lower than that of the low-risk group. Univariate and multivariate independent prognostic analyses showed that patients’ age, pathological grade, and FIGO stage were all risk factors for poor prognosis. A clinical correlation analysis of the relationship between the five autophagy-related lncRNAs and patients’ age, pathological grade, and FIGO stage was also per https://orcid.org/0000-0001-7090-1750 formed. Histopathological assessment of the tumor microenvironment showed that the ESTIMATE, immune, and stromal scores in the high-risk group were lower than those in the low-risk group. Principal component analysis and functional annotation were performed to confirm the correlations. To further evaluate the effect of the model constructed on prognosis, samples were divided into training (60%) and validation (40%) groups, regarding the risk status as an independent prognostic risk factor. A prognostic nomogram was constructed using patients’ age, pathological grade, FIGO stage, and risk status to estimate the patients’ survival rate. C-index and multi-index ROC curves were generated to verify the stability and accuracy of the nomogram. From this analysis, we concluded that the five lncRNAs identified in this study could affect the incidence and development of endometrial cancer by regulating the autophagy process. Therefore, these molecules may have the potential to serve as novel therapeutic targets and biomarkers.

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A multivariate analysis of blood vessel and lymph vessel invasion as predictors of ovarian and lymph node metastases in patients with cervical carcinoma

Cancer ◽

10.1002/1097-0142(20000601)88:11<2578::aid-cncr21>3.0.co;2-y ◽

2000 ◽

Vol 88 (11) ◽

pp. 2578-2583 ◽

Cited By ~ 61

Author(s):

Noriaki Sakuragi ◽

Naoki Takeda ◽

Hitoshi Hareyama ◽

Toshio Fujimoto ◽

Yukiharu Todo ◽

...

Keyword(s):

Multivariate Analysis ◽

Lymph Node ◽

Blood Vessel ◽

Cervical Carcinoma ◽

Lymph Node Metastases ◽

Lymph Vessel ◽

Lymph Vessel Invasion ◽

Vessel Invasion ◽

Node Metastases

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Incomplete inside-out growth pattern in invasive breast carcinoma: association with lymph vessel invasion and recurrence-free survival

Virchows Archiv ◽

10.1007/s00428-010-1033-2 ◽

2011 ◽

Vol 458 (2) ◽

pp. 159-169 ◽

Cited By ~ 9

Author(s):

Sayaka Kuba ◽

Hiroshi Ohtani ◽

Junzo Yamaguchi ◽

Hiroko Hayashi ◽

Tatsuya Uga ◽

...

Keyword(s):

Breast Carcinoma ◽

Growth Pattern ◽

Invasive Breast Carcinoma ◽

Lymph Vessel ◽

Recurrence Free Survival ◽

Free Survival ◽

Lymph Vessel Invasion ◽

Vessel Invasion ◽

Inside Out

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Detection of Lymphovascular Invasion by D2-40 (Podoplanin) Immunoexpression in Endometrial Cancer

International Journal of Gynecological Cancer ◽

10.1097/igc.0b013e318269139b ◽

2012 ◽

Vol 22 (8) ◽

pp. 1442-1448 ◽

Cited By ~ 25

Author(s):

Sarah K. Weber ◽

Axel Sauerwald ◽

Martin Pölcher ◽

Michael Braun ◽

Manuel Debald ◽

...

Keyword(s):

Overall Survival ◽

Endometrial Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Lymphovascular Invasion ◽

Lymph Node Involvement ◽

Lymph Vessel ◽

Node Metastasis ◽

Lymph Vessel Invasion ◽

Node Involvement

BackgroundLymph node involvement is a major feature in tumor spread of endometrial cancer and predicts prognosis. Therefore, evaluation of lymph vessel invasion (LVI) in tumor tissue as a predictor for lymph node metastasis is of great importance. Immunostaining of D2-40 (podoplanin), a specific marker for lymphatic endothelial cells, might be able to increase the detection rate of LVI compared with conventional hematoxylin-eosin (H-E) staining. The aim of this retrospective study was to analyze the eligibility of D2-40–based LVI evaluation for the prediction of lymph node metastases and patients’ outcome.Patients and MethodsImmunohistochemical staining with D2-40 monoclonal antibodies was performed on paraffin-embedded tissue sections of 182 patients with primary endometrioid adenocarcinoma treated in 1 gynecologic cancer center. Tumors were screened for the presence of LVI. Correlations with clinicopathological features and clinical outcome were assessed.ResultsImmunostaining of D2-40 significantly increased the frequency LVI detection compared with conventional H-E staining. Lymph vessel invasion was identified by D2-40 in 53 (29.1%) of 182 tumors compared with 34 (18.3%) of 182 carcinomas by routine H-E staining (P = 0.001). D2-40 LVI was detectable in 81.0% (17/21) of nodal-positive tumors and significantly predicted lymph node metastasis (P = 0.001). Furthermore, D2-40 LVI was an independent prognostic factor for patients overall survival considering tumor stage, lymph node involvement, and tumor differentiation (P < 0.01). D2-40–negative tumors confined to the inner half of the myometrium showed an excellent outcome (5-year overall survival, 97.8%).ConclusionsD2-40–based LVI assessment improves the histopathological detection of lymphovascular invasion in endometrial cancer. Furthermore, LVI is of prognostic value and predicts lymph node metastasis. D2-40 LVI detection might help to select endometrial cancer patients who will benefit from a lymphadenectomy.

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Prognostic significance of lymphovascular space invasion in low-risk endometrial cancer

International Journal of Gynecological Cancer ◽

10.1136/ijgc-2018-000069 ◽

2019 ◽

Vol 29 (3) ◽

pp. 505-512 ◽

Cited By ~ 3

Author(s):

Ali Ayhan ◽

Hanifi Şahin ◽

Mustafa Erkan Sari ◽

Ibrahim Yalçin ◽

Ali Haberal ◽

...

Keyword(s):

Overall Survival ◽

Endometrial Cancer ◽

Survival Rate ◽

Survival Data ◽

Gynecologic Oncology ◽

Prognostic Significance ◽

Myometrial Invasion ◽

Low Risk ◽

Pathology Reports ◽

Lymphovascular Space Invasion

ObjectiveThe purpose of this study was to assess the prognostic significance of lymphovascular space invasion in women with low-risk endometrial cancer.MethodsA dual-institutional, retrospective department database review was performed to identify patients with ‘low-risk endometrial cancer’ (patients having <50% myometrial invasion with grade 1 or 2 endometrioid endometrial cancer according to their final pathology reports) at two gynecologic oncology centers in Ankara, Turkey. Demographic, clinicopathological and survival data were collected.ResultsWe identified 912 women with low-risk endometrial cancer; 53 patients (5.8%) had lymphovascular space invasion. When compared with lymphovascular space invasion-negative patients, lymphovascular space invasion-positive patients were more likely to have post-operative grade 2 disease (p<0.001), deeper myometrial invasion (p=0.003), and larger tumor size (p=0.005). Patients with lymphovascular space invasion were more likely to receive adjuvant therapy when compared with lymphovascular space invasion-negative women (11/53 vs 12/859, respectively; p<0.001). The 5-year recurrence-free survival rate for lymphovascular space invasion-positive women was 85.5% compared with 97.0% for lymphovascular space invasion-negative women (p<0.001). The 5-year overall survival rate for lymphovascular space invasion-positive women was significantly lower than that of lymphovascular space invasion-negative women (88.2% vs 98.5%, respectively; p<0.001). Age ≥60 years (HR 3.13, 95% CI 1.13 to 8.63; p=0.02) and positive lymphovascular space invasion status (HR 6.68, 95% CI 1.60 to 27.88; p=0.009) were identified as independent prognostic factors for decreased overall survival.ConclusionsAge ≥60 years and positive lymphovascular space invasion status appear to be important prognostic parameters in patients with low-risk endometrial cancer who have undergone complete surgical staging procedures including pelvic and para-aortic lymphadenectomy. Lymphovascular space invasion seems to be associated with an adverse prognosis in women with low-risk endometrial cancer; this merits further assessment on a larger scale with standardization of the lymphovascular space invasion in terms of presence/absence and quantity.

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Significance of lymph vessel invasion identified by the endothelial lymphatic marker D2-40 in node negative breast cancer

Modern Pathology ◽

10.1038/modpathol.3800728 ◽

2007 ◽

Vol 20 (2) ◽

pp. 183-191 ◽

Cited By ~ 82

Author(s):

Angel Arnaout-Alkarain ◽

Harriette J Kahn ◽

Steven A Narod ◽

Ping A Sun ◽

Alexander N Marks

Keyword(s):

Breast Cancer ◽

Lymph Vessel ◽

Node Negative ◽

Lymph Vessel Invasion ◽

Vessel Invasion ◽

Node Negative Breast Cancer

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Prognostic Impact of Perineural, Blood and Lymph Vessel Invasion for Esophageal Cancer Patients

Journal of Surgical Research ◽

10.1016/j.jss.2011.11.374 ◽

2012 ◽

Vol 172 (2) ◽

pp. 239-240

Author(s):

M. Tachezy ◽

A. Tiebel ◽

F. Gebauer ◽

A. Marx ◽

K. Pantel ◽

...

Keyword(s):

Esophageal Cancer ◽

Cancer Patients ◽

Lymph Vessel ◽

Prognostic Impact ◽

Lymph Vessel Invasion ◽

Vessel Invasion

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Clinicopathological Features as Prognostic Predictors of Poor Outcome in Papillary Thyroid Carcinoma

Cancers ◽

10.3390/cancers12113186 ◽

2020 ◽

Vol 12 (11) ◽

pp. 3186

Author(s):

Antónia Afonso Póvoa ◽

Elisabete Teixeira ◽

Maria Rosa Bella-Cueto ◽

Miguel Melo ◽

Maria João Oliveira ◽

...

Keyword(s):

Venous Invasion ◽

Lateral Compartment ◽

Male Gender ◽

Clinicopathological Features ◽

Lymph Vessel ◽

Resection Margins ◽

Papillary Thyroid ◽

Lymph Vessel Invasion ◽

Vessel Invasion

Papillary thyroid cancer (PTC) has an indolent nature and usually excellent prognosis. Some PTC clinicopathological features may contribute to the development of aggressive metastatic disease. In this work, we want to evaluate PTC clinicopathological features that are presurgical prognostic predictors of patients’ outcomes and find which indicators are more adequate for tailoring surgical procedures and follow-up. We studied a series of 241 PTC patients submitted to surgery. All patients’ files and histological tumor samples were reviewed. The 8th edition AJCC/UICC (American Joint Committee on Cancer/Union for International Cancer) Controlstaging system and the 2015 American Thyroid Association risk stratification system were used. Total thyroidectomy was performed in 228 patients, lymphadenectomy in 28 patients. Gross extrathyroidal extension (ETE) was present in 10 patients and 31 tumor resection margins were incomplete. Cervical lymph node metastases (LNMs) were present in 34 patients and distant metastases at diagnosis in four patients. In multivariate analysis, male gender (OR = 15.4, p = 0.015), venous invasion (OR = 16.7, p = 0.022), and lateral compartment LNM (OR = 26.7, p = 0.004) were predictors of mortality; psammoma bodies (PBs) (OR = 4.5, p = 0.008), lymph vessel invasion (OR = 6.9, p < 0.001), and gross ETE (OR = 16.1, p = 0.001) were predictors of structural disease status; male gender (OR = 2.9, p = 0.011), lymph vessel invasion (OR = 2.8, p = 0.006), and incomplete resection margins (OR = 4.6, p < 0.001) were predictors of recurrent/persistent disease. Our study supports that the factors helping to tailor patient’s surgery are male gender, presence of PBs, gross ETE, and lateral compartment LNM. Together with pathological factors, lymph vessel invasion, venous invasion, necrosis, and incomplete surgical resection, should be taken into consideration regarding treatment and follow-up of patients.

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