[1106] Clinical Significance of Lymphovascular Space Invasion in Uterine Serous Carcinoma

Sudeshna Bandyopadhyay, Ira Winer, Ismail Mert, Esther Oliva, Marisa Nucci, Zaid Al-Wahab, Hui Guan, Haitham Arabi, Baraa Alosh, Koen K Van de Vijver, Rouba Ali-Fehmi. Wayne State University, Detroit, MI; Massachusetts General Hospital, Boston, MA; Brigham and Women's Hospital, Boston, MA; King Abdulaziz Medical City, Jiddah, Saudi Arabia

Background: Uterine serous carcinoma, although less common, is responsible for a larger proportion of uterine cancer related deaths. Vascular space invasion has been identified as a prognostic factor. The aim of our study was to analyze the clinical significance of extensive, low or absence of lymphovascular space invasion (LVSI) in uterine serous carcinoma (USC) patients.
Design: After IRB approval, 236 USC from the pathology databases of 4 large academic institutions were included. H&E slides (2-10 slides per case) were retrieved and reviewed by a gynecologic pathologist at each participating institution after reviewing 50 cases as a group to be consistent in the diagnosis. LVSI information was available for 151 patients. Patients were divided into three groups based on LVSI extent. Extensive LVSI (E-LVSI) was defined as ≥ 3 vessel involvement; Low LVSI (L-LVSI) was defined as less than 3 vessel involvement and the last group was absent LVSI (A-LVSI).
Results: Out of these 151 patients, 65 had A-LVSI, 55 had L-LVSI, and 31 had E-LVSI. Please see table for the association between LVSI and LN involvement, washing, myometrial invasion, cervical involvement, lower uterine segment involvement (LUS), and stage. Analyzing only stage I and stage II disease (n=68) for survival and recurrence, demonstrated a median survival of 177 months, 155 months and 34 months in the A-LVSI, L-LVSI and E-LVSI groups.

 A-LVSI (65)L-LVSI (55)E-LVSI (31) 
+ LN15.4%27.3 %83.9%*
+ Washing18.8 %24 %37 %NS
Myometrial Invasion58 %85 %100%*
Cervical Invasion23 %43 %66 %*
Lower Uterine Segment Invasion34 %55 %77 %*
Stage III & IV31 %40 %78 %*
* p< 0.05

Conclusions: In this large multicenter retrospective analysis, the extent LVSI was associated with multiple pathologic factors and had significant clinical implications in terms of survival and disease recurrence in early stage disease suggesting careful attention must be paid not only to the presence of LVSI but its extent in USC.
Category: Gynecologic & Obstetrics

Tuesday, March 5, 2013 9:30 AM

Poster Session III # 119, Tuesday Morning


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