Effect of lymphovascular space invasion on survival of stage I epithelial ovarian cancer.
Effect of lymphovascular space invasion on survival of stage I epithelial ovarian cancer.
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DOI：
10.1097/aog.0000000000000240
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发表时间：
2014-05
影响因子：
7.2
通讯作者：
Sood AK
中科院分区：
文献类型：
--
作者：
Matsuo K;Yoshino K;Hiramatsu K;Banzai C;Hasegawa K;Yasuda M;Nishimura M;Sheridan TB;Ikeda Y;Shiki Y;Mabuchi S;Enomoto T;Kimura T;Fujiwara K;Roman LD;Sood AK
探讨淋巴血管腔浸润对早期上皮性卵巢癌患者生存的影响。一项多中心回顾性研究对IA-C期上皮性卵巢癌患者进行了包括淋巴结切除术在内的原发性综合手术。卵巢肿瘤的组织病理切片由妇科病理医师检查有无淋巴血管间隙浸润。对肿瘤因素进行生存分析。共有434例病例纳入分析。淋巴血管浸润76例（17.5%），与组织学（p=0.042）和分期（p=0.044）相关。单因素分析中，淋巴血管间隙侵犯与生存结果降低显著相关（无病生存[DFS]， 5年生存率78.4%比90.7%,p=0.024，总生存率[OS]， 84.9%比93.2%,p=0.031）。在多因素分析中，淋巴血管腔浸润不再是影响DFS（风险比[HR] 1.98, 95%CI 0.97-3.97, p=0.059）或OS（风险比[HR] 2.41, 95%CI 0.99-5.85, p=0.052）的重要因素。在多因素分析中，淋巴血管腔浸润与血液和淋巴转移的风险增加相关（HR 4.79, 95%CI 1.75-13.2, p=0.002），但与腹膜转移无关（p=0.33）。在淋巴血管腔浸润表达肿瘤中，术后化疗周期少于6个周期的患者的DFS明显低于化疗周期大于或等于6个周期的患者（HR 4.59, 95%CI 1.20-17.5, p=0.015）。淋巴血管间隙浸润是识别I期上皮性卵巢癌复发风险增加亚组患者的重要组织学特征。
To evaluate the effect of lymphovascular space invasion on survival of early-stage epithelial ovarian cancer patients. A multicenter retrospective study was conducted for patients with stage IA-C epithelial ovarian cancer who underwent primary comprehensive surgery including lymphadenectomy. Histopathology slides for ovarian tumors were examined by gynecologic pathologists for presence or absence of lymphovascular space invasion. Survival analysis was performed examining tumoral factors. A total of 434 cases were included in the analysis. Lymphovascular space invasion was detected in 76 (17.5%) cases, associated with histology (p=0.042) and stage (p=0.044). Lymphovascular space invasion was significantly associated with decreased survival outcomes (disease-free survival [DFS], 5-year rate 78.4% versus 90.7%, p=0.024, and overall survival [OS], 84.9% versus 93.2%, p=0.031) in univariate analysis. In multivariate analysis, lymphovascular space invasion did not remain a significant variable for DFS (hazard ratio [HR] 1.98, 95%CI 0.97-3.97, p=0.059) or OS (HR 2.41, 95%CI 0.99-5.85, p=0.052). Lymphovascular space invasion was associated with increased risk of hematogenous and lymphatic metastasis (HR 4.79, 95%CI 1.75-13.2, p=0.002) but not peritoneal metastasis (p=0.33) in multivariate analysis. Among lymphovascular space invasion-expressing tumors, patients who received fewer than 6 cycles of postoperative chemotherapy had significantly poorer DFS than those who received six or more cycles (HR 4.59, 95%CI 1.20-17.5, p=0.015). Lymphovascular space invasion is an important histological feature to identify a subgroup of patients with increased risk of recurrence in stage I epithelial ovarian cancer.