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528 Lymphovascular space invasion: a predictive factor for locoregional control and survival in early endometrial cancer
  1. Alia Mousli1,
  2. Cyrine Mokrani1,
  3. Fatma Saadallah2,
  4. Khadija Ben Zid1,
  5. Semia Zarraa1,
  6. Safia Yahiaoui1,
  7. Rim Abidi1 and
  8. Chiraz Nasr1
  1. 1Radiotherapy departement, Salah Azaiz Institute, Tunis, Tunisia
  2. 2Oncologic surgery departement, Salah Azaiz Institute, Tunis, Tunisia

Abstract

Introduction/Background Lymphvascular space invasion (LVSI) has consistently emerged as an independent negative prognostic factor for survival in endometrial cancer. The FIGO 2023 endometrial cancer staging has recently integrated LVSI as a prognosis factor, aiding in the identification of patients with a higher aggressive disease. The aim of the study is to evaluate the impact of LVSI on the 5-year locoregional control and metastasis-free survival in endometrial cancer.

Methodology Retrospective study including 214 patients treated for endometrial cancer between 2005 and 2015 in the radiotherapy (RT) department at Salah Azaiz Institute in Tunisia.

Results The median age at diagnosis was 58.9 years. Endometrioid adenocarcinoma was identified in 162 patients (75.5%), with grade1, 2, 3 in respectively 50.8%, 30% and 19.2% of patients. Histological type 2 was observed in forty cases (18.7 %). According to FIGO 2009, 82.4% were classified in early stages respectively, 60% and 22.4% for stage I and II. LVSI was noted in 13.4% of early stage patients. All patients underwent total hysterectomy with bilateral annexectomy. The bilateral pelvic lymphadenectomy was performed in 75% of cases. In the intermediate-risk group of stage I, two-thirds of patients underwent adjuvant pelvic RT. All patients from stade II underwent adjuvant pelvic RT. All patients underwent postoperative high-dose-rate vaginal brachytherapy including low risk group. The 5-year locoregional control rate was 87.7% in the absence of lymphovascular space invasion compared to 58.5% in their presence (p<0.01). Multivariate analysis identified FIGO staging and LVSI as the two independent factors in locoregional recurrence-free survival (p<0.05). Metastasis-free survival at 5 years was 48% in the presence of lymphovascular space invasion, contrasting with 84% in their absence (p<0.001).

Conclusion Our findings align with the updated FIGO staging guidelines and emphasize the significance of lymphovascluar space invasion in guiding treatment decisions for endometrial cancer.

Disclosures The authors declare no competing interests.

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