LVSI positive and NX in early endometrial cancer: Surgical restaging (and no further treatment if N0), or adjuvant ERT?

Katherine L Harris; Kathryn A Maurer; Elke Jarboe; Theresa L Werner; David Gaffney

doi:10.1016/j.ygyno.2019.09.016

LVSI positive and NX in early endometrial cancer: Surgical restaging (and no further treatment if N0), or adjuvant ERT?

Gynecol Oncol. 2020 Jan;156(1):243-250. doi: 10.1016/j.ygyno.2019.09.016. Epub 2019 Nov 5.

Authors

Katherine L Harris¹, Kathryn A Maurer², Elke Jarboe³, Theresa L Werner⁴, David Gaffney⁵

Affiliations

¹ Huntsman Cancer Institute, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Utah, 30 North 1900 East, Salt Lake City, UT, 84132, USA. Electronic address: kate.harris@hci.utah.edu.
² Huntsman Cancer Institute, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Utah, 30 North 1900 East, Salt Lake City, UT, 84132, USA.
³ Huntsman Cancer Institute, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Utah, 30 North 1900 East, Salt Lake City, UT, 84132, USA; Department of Anatomic Pathology, 15 N Medical Dr Suite 1100, Salt Lake City, UT, 84112, USA.
⁴ Huntsman Cancer Institute, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA; Division of Oncology, Department of Medicine, University of Utah School of Medicine, 2000 Circle of Hope, Suite 2100, Salt Lake City, UT, 84132, USA.
⁵ Huntsman Cancer Institute, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA; Department of Radiation Oncology, University of Utah School of Medicine, 1950 Circle of Hope, Rm 1570, Salt Lake City, UT, 84112, USA.

PMID: 31703813
DOI: 10.1016/j.ygyno.2019.09.016

Abstract

Early endometrial cancer has an overall survival of greater than 80% (1). One of the poor prognostic factors that may be associated with the 20% who do not survive 5 years is the presence of lymphovascular space invasion (LVSI). LVSI is associated with increased nodal metastasis and decreased progression free survival (PFS) and overall survival (OS). (2-8). Therefore, unstaged, LVSI positive early endometrial cancer requires additional management with either completion of staging with lymphadenectomy or adjuvant radiation. We focus on reviewing the management of natural history and management of early endometrial cancer followed by the prognostic impact of LVSI, management options and recommendations.

Keywords: Adjuvant treatment; Early endometrial cancer; Lymphovascular space invasion; Unstaged.

Publication types

Review

MeSH terms

Endometrial Neoplasms / pathology*
Endometrial Neoplasms / radiotherapy
Endometrial Neoplasms / surgery
Endometrial Neoplasms / therapy*
Female
Humans
Lymphatic Metastasis
Lymphatic System / pathology
Neoplasm Staging
Radiotherapy, Adjuvant