Extensive versus focal lymphovascular invasion in squamous cell carcinoma of the cervix: A comprehensive international, multicenter, retrospective clinicopathologic study Journal Article
| Authors: | Praiss, A. M.; Allison, D.; Tessier-Cloutier, B.; Flynn, J.; Iasonos, A.; Hoang, L.; Patrichi, A.; Terinte, C.; Pesci, A.; Mateoiu, C.; Lastra, R. R.; Puscasiu, L.; Kiyokawa, T.; Ali-Fehmi, R.; Kheil, M.; Oliva, E.; Devins, K. M.; Abu-Rustum, N. R.; Soslow, R. A.; Stolnicu, S. |
| Article Title: | Extensive versus focal lymphovascular invasion in squamous cell carcinoma of the cervix: A comprehensive international, multicenter, retrospective clinicopathologic study |
| Abstract: | Objective: We evaluated clinicopathologic parameters of patients with cervical squamous cell carcinoma (SCC) who were treated with initial surgical management and assessed their relation to survival outcomes. Specifically, we evaluated the relation between extent of lymphovascular invasion (LVI) and survival outcomes. Methods: All available tumor slides from patients with initially surgically treated cervical SCC were collected from 10 institutions and retrospectively analyzed. Standard clinicopathological parameters, tumor stroma, and extent of LVI were assessed (focal: <5 spaces, extensive: ≥5 spaces). PFS and OS were evaluated using Kaplan–Meier methodology. Univariable and multivariable Cox proportional hazards models were created to determine prognostic survival-related risk factors. Results: A total of 670 tumor samples were included in the analysis. Median age at diagnosis was 47 years (IQR: 38–60), 457 patients (72%) had a 2018 International Federation of Gynecology and Obstetrics (FIGO) stage I tumor, and 155 tumors (28%) were flat and/or ulcerated. There were 303 nonkeratinizing tumors (51%), 237 keratinizing tumors (40%), and 356 histologic grade 2 tumors (61%). Quantifiable LVI was present in 321 cases (51%; 23% focal and 33% extensive). On multivariable analysis for PFS, extensive and focal LVI had worse outcomes compared to negative LVI (HR: 2.38 [95% CI: 1.26–4.47] and HR: 1.54 [95% CI: 0.76–3.11], respectively; P = 0.02). The difference did not reach statistical significance for OS. Conclusion: Presence of LVI is a prognostic marker for patients with cervical SCC. Quantification (extensive vs. focal vs. negative) of LVI may be an important biomarker for oncologic outcome. © 2023 Elsevier Inc. |
| Keywords: | immunohistochemistry; adult; cancer survival; controlled study; middle aged; cancer surgery; major clinical study; microscopy; squamous cell carcinoma; cancer staging; hysterectomy; lymph node dissection; pelvis lymph node; progression free survival; retrospective study; multicenter study; cervix; radical hysterectomy; surgical margin; uterine cervix conization; lymphovascular invasion; tumor invasion; international federation of gynecology and obstetrics; depth of invasion; lymph vessel metastasis; prognosis; human; female; article; cervical squamous cell carcinoma; cervicotomy; loop electrosurgical excision |
| Journal Title: | Gynecologic Oncology |
| Volume: | 176 |
| ISSN: | 0090-8258 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2023-09-01 |
| Start Page: | 147 |
| End Page: | 154 |
| Language: | English |
| DOI: | 10.1016/j.ygyno.2023.07.011 |
| PUBMED: | 37541128 |
| PROVIDER: | scopus |
| PMCID: | PMC10809424 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in PubMed and PDF -- Source: Scopus |
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