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Prognostic value of lymphovascular space invasion in early-stage cervical cancer
  1. Ariane Weyl1,
  2. Claire Illac2,
  3. Amélie Lusque3,
  4. Hélène Leray4,
  5. Charlotte Vaysse1,
  6. Alejandra Martinez4,
  7. Elodie Chantalat1 and
  8. Stephanie Motton1
  1. 1 Gynecologic Surgery, CHU Toulouse, Toulouse, Midi-Pyrénées, France
  2. 2 Pathology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, Languedoc-Roussillon-Midi, France
  3. 3 Biostatistics, Institute Claudius Regaud, Toulouse, Occitanie, France
  4. 4 Oncologic Surgery, Institute Claudius Regaud, Toulouse, Occitanie, France
  1. Correspondence to Dr Ariane Weyl, Gynecologic Surgery, CHU Toulouse, Toulouse 31400, France; ariane.weyl{at}


Objective Few prognostic factors likely to influence therapeutic management of early-stage cervical cancer are currently recognized. The objective of this study was to determine the prognostic value of lymphovascular space invasion (LVSI) in overall survival of patients with early-stage cervical cancer.

Methods This is a retrospective study of patients treated for early-stage cervical cancer between January 1996 and December 2013 at Toulouse University Hospital and the Cancer Center Claudius Regaud Institute. Patients were included if they had FIGO 2018 stage IA1, IA2, IB1/2, or IIA1 cervical cancer. All patients had to have had surgery (conization, radical hysterectomy, or radical trachelectomy). The presence of LVSI was evaluated in the initial anatomic pathology reports of the excised tissue. The presence of LVSI was defined by the presence of epithelial tumor cells in the lumen of vessels, lined by endothelial cells. If the data were missing, the slides were reviewed by an expert pathologist. Comparative analyses of patient populations with and without LVSI invasion were performed, as well as analyses of overall and disease-free survival.

Results A total of 158 patients were included in the analysis. Seventy-two (45.6%) patients had LVSI. More patients with LVSI received external radiotherapy in addition to standard treatment than patients without LVSI (53% vs 14%, p<0.0001). The overall survival of patients with LVSI (89.8%) was similar to that of patients without LVSI (91.5%) (p=0.39). For patients without lymph node involvement but with LVSI, disease-free survival at 5 years tended to be higher among those treated with external radiotherapy in addition to standard treatments (92.6% vs 79.8%, difference not tested due to the small number of events).

Conclusion Patients with early-stage cervical cancer with LVSI received external radiotherapy more often, and therefore had an overall survival at 5 years identical to patients without LVSI.

  • cervical Cancer
  • pathology
  • radiotherapy
  • lymphatic vessels
  • surgical oncology

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  • Contributors AW: investigation, methodology, writing - original draft. CI: investigation, material resources. AL: formal analysis, data curation. HL: investigation. CV: writing - review & editing. AM: writing - review & editing. EC: writing - review & editing, conceptualisation. SM: conceptualisation, supervision, writing - review & editing.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. Patient data are available in an institutional database, at the IUCT Oncopole Toulouse. Statistical analysis plans are available upon request at