910e1f81b8732c3ace632cb97b7cdc2a pmc_10177148.pdf 94bba8b8f63f4eb6bc4f5fdd1d241e679332cab7 pmc_10177148.pdf c35fd5fd4828fbcceecc33fec82fc8ab20978bd3003d058fc20ddfa017e24179 pmc_10177148.pdf Title: Lymphovascular Space Invasion in Early-Stage Endometrial Cancer (LySEC): Patterns of Recurrence and Predictors.A Multicentre Retrospective Cohort Study of the Spain Gynecologic Oncology Group Subject: The main aim is to compare oncological outcomes and patterns of recurrence of patients with early-stage endometrioid endometrial cancer according to lymphovascular space invasion (LVSI) status. The secondary objective is to determine preoperative predictors of LVSI. We performed a multicenter retrospective cohort study. A total of 3546 women diagnosed with postoperative early-stage (FIGO I-II, 2009) endometrioid endometrial cancer were included. Co-primary endpoints were disease-free survival (DFS), overall survival (OS), and pattern of recurrence. Cox proportional hazard models were used for time-to-event analysis. Univariate and multivariate logistical regression models were employed. Positive LVSI was identified in 528 patients (14.6%) and was an independent prognostic factor for DFS (HR 1.8), OS (HR 2.1) and distant recurrences (HR 2.37). Distant recurrences were more frequent in patients with positive LVSI (78.2% vs. 61.3%, p < 0.01). Deep myometrial invasion (OR 3.04), high-grade tumors (OR 2.54), cervical stroma invasion (OR 2.01), and tumor diameter 2 cm (OR 2.03) were independent predictors of LVSI. In conclusion, in these patients, LVSI is an independent risk factor for shorter DFS and OS, and distant recurrence, but not for local recurrence. Deep myometrial invasion, cervical stroma invasion, high-grade tumors, and a tumor diameter 2 cm are independent predictors of LVSI. Keywords: endometrial cancer; recurrence; survival; LVSI; lymphovascular space invasion Author: M Reyes Oliver-Perez, Pablo Padilla-Iserte, Octavio Arencibia-Sanchez, Cristina Martin-Arriscado, Juan Carlos Muruzabal, Berta Diaz-Feijóo, Silvia Cabrera, Pluvio Coronado, M Belen Martín-Salamanca, Manuel Pantoja-Garrido, Josefa Marcos-Sanmartin, Elena Cabezas-López, Cristina Lorenzo, Duska Beric, Jose Ramon Rodriguez-Hernandez, Fernando Roldan-Rivas, Juan Gilabert-Estelles, Lourdes Sanchez, Maria Laseca-Modrego, Carmen Tauste-Rubio, Blanca Gil-Ibañez, Alvaro Tejerizo-Garcia and on behalf of the Spain-GOG Group Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Fri May 5 10:31:33 2023 CEST ModDate: Fri May 5 10:42:08 2023 CEST Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 12 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 907621 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- FDPKDP+VnURWPalladioL Type 1 Custom yes yes no 10 0 KJEEHF+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 UFRSPG+URWPalladioL-Roma Type 1 Custom yes yes no 20 0 MAJVHI+URWPalladioL-Ital Type 1 Custom yes yes no 24 0 YWWVQQ+VnURWPalladioL-Bold Type 1 Custom yes yes no 28 0 LCJEVJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 47 0 OHXQCJ+CMSY10 Type 1 Builtin yes yes no 69 0 KDJOKB+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 83 0 KDJOKC+PalatinoLinotype CID TrueType Identity-H yes yes yes 86 0 KDJOKD+PalatinoLinotype TrueType WinAnsi yes yes no 92 0 KDJOKE+PalatinoLinotype,Italic CID TrueType Identity-H yes yes yes 95 0 KDJOKF+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 101 0 KDJPJA+PalatinoLinotype TrueType MacRoman yes yes no 104 0 QLBIEB+URWPalladioL-BoldItal Type 1 Custom yes yes no 114 0 KDJOKB+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 128 0 KDJOKC+PalatinoLinotype CID TrueType Identity-H yes yes yes 131 0 KDJOKD+PalatinoLinotype TrueType WinAnsi yes yes no 137 0 KDJOKF+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 140 0 KDJPJA+PalatinoLinotype TrueType MacRoman yes yes no 143 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-02-02 02:35:03 CET RepresentationInformation: pmc_10177148.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2023-10-02 02:27:41 CEST Size: 907621 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 334 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Study Design, Setting, and Oversight Destination: subsection.2.1 Item: Title: Cohort Selection and Study Variables Destination: subsection.2.2 Item: Title: Outcomes Destination: subsection.2.3 Item: Title: Statistical Analysis Destination: subsection.2.4 Item: Title: Results Destination: section.3 Children: Item: Title: Study Population Destination: subsection.3.1 Item: Title: Survival Analysis According to LVSI Status Destination: subsection.3.2 Item: Title: Patterns of Recurrence Destination: subsection.3.3 Item: Title: Predictors of LVSI Destination: subsection.3.4 Item: Title: Discussion Destination: section.4 Children: Item: Title: Main Findings Destination: subsection.4.1 Item: Title: Results in the Context of Published Literature Destination: subsection.4.2 Item: Title: Strengths and Limitations Destination: subsection.4.3 Item: Title: Implications for Future Research and Practice Destination: subsection.4.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.A. Info: Title: Lymphovascular Space Invasion in Early-Stage Endometrial Cancer (LySEC): Patterns of Recurrence and Predictors.A Multicentre Retrospective Cohort Study of the Spain Gynecologic Oncology Group Author: M Reyes Oliver-Perez, Pablo Padilla-Iserte, Octavio Arencibia-Sanchez, Cristina Martin-Arriscado, Juan Carlos Muruzabal, Berta Diaz-Feijóo, Silvia Cabrera, Pluvio Coronado, M Belen Martín-Salamanca, Manuel Pantoja-Garrido, Josefa Marcos-Sanmartin, Elena Cabezas-López, Cristina Lorenzo, Duska Beric, Jose Ramon Rodriguez-Hernandez, Fernando Roldan-Rivas, Juan Gilabert-Estelles, Lourdes Sanchez, Maria Laseca-Modrego, Carmen Tauste-Rubio, Blanca Gil-Ibañez, Alvaro Tejerizo-Garcia and on behalf of the Spain-GOG Group Subject: The main aim is to compare oncological outcomes and patterns of recurrence of patients with early-stage endometrioid endometrial cancer according to lymphovascular space invasion (LVSI) status. The secondary objective is to determine preoperative predictors of LVSI. We performed a multicenter retrospective cohort study. A total of 3546 women diagnosed with postoperative early-stage (FIGO I-II, 2009) endometrioid endometrial cancer were included. Co-primary endpoints were disease-free survival (DFS), overall survival (OS), and pattern of recurrence. Cox proportional hazard models were used for time-to-event analysis. Univariate and multivariate logistical regression models were employed. Positive LVSI was identified in 528 patients (14.6%) and was an independent prognostic factor for DFS (HR 1.8), OS (HR 2.1) and distant recurrences (HR 2.37). Distant recurrences were more frequent in patients with positive LVSI (78.2% vs. 61.3%, p < 0.01). Deep myometrial invasion (OR 3.04), high-grade tumors (OR 2.54), cervical stroma invasion (OR 2.01), and tumor diameter 2 cm (OR 2.03) were independent predictors of LVSI. In conclusion, in these patients, LVSI is an independent risk factor for shorter DFS and OS, and distant recurrence, but not for local recurrence. Deep myometrial invasion, cervical stroma invasion, high-grade tumors, and a tumor diameter 2 cm are independent predictors of LVSI. 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