Prognostic Importance of Lymph-Vascular Space Involvement in Stage I Endometrioid Type Endometrial Cancer

Objective: The study aimed to investigate the prognostic significance of lymph-vascular space invasion (LVSI) in patients with stage I endometrioid-type endometrial carcinoma (EC) and to determine its impact on overall survival (OS) and disease-free survival (DFS). Methods: Medical records of 611 patients with stage I endometrioid-type EC who underwent surgery at our Ankara Dr. Zekai Tahir Burak Women's Health Training and Research Hospital Gynecology Clinic were retrospectively analyzed. The patients were divided into two groups based on the presence or absence of LVSI. The primary outcome measures were DFS and OS, and the prognostic significance of LVSI was assessed using univariate and multivariate analyses. Results: We identified 52 LVSI-positive patients among 611 patients with stage I endometrioid EC during the study period; 489 (80%) were classified as stage IA and 122 (20%) as stage IB. The total number of recurrences was 26 (4.3%). LVSI was observed in only 4 patients with recurrence (15.3%). For the LVSI positive patients, the 5-year DFS was 88.7%, whereas the 5-year OS rate was 91.6%. Age >60 years [hazard ratio (HR) 4.08, 95% confidence interval (CI) 1.57-10.59; p=0.004] and tumor size >2.8 cm (HR 2.48, 95%, CI 1.001-6.148; p=0.05) were found to be independent prognostic factors of decreased OS. Conclusion: We found that LVSI in stage I endometrioid-type EC was not a significant predictor of DFS and OS. Patient's age and tumor size were independent prognostic factors of crude survival. These results suggest that LVSI may not be a useful prognostic marker in this patient population and that further studies are needed to identify more reliable predictors of survival in EC.