자궁에 국한된 자궁내막암에서 림프혈관 침윤의 예후인자로서의 중요성

Abstract

Objective We evaluated whether or not lymphovascular space involvement (LVSI) is a risk factor for the relapse of disease in patients with uterine-confi ned endometrioid endometrial cancer. Methods A retrospective chart review was carried out of 165 patients with uterine confi ned endoemtrioid-type endometrial cancer after initial treatments including total abdominal or laparoscopic hysterectomy, and bilateral salpingo-oophorectomy, with or without lymphadenectomy, peritoneal washing between 1998 and 2010. The patients with positive peritoneal cytology were not excluded. Results The median age was 52 years (range, 26 to 81 years) with a median follow-up of 46 months (range, 1 to 144 months). One hundred twenty-four patients (75.2%) received no adjuvant treatment, 41 patients (24.8%) received adjuvant treatment including platinumbased chemotherapy, radiation therapy, and chemoradiation. LVSI was present in 29 patients (17.6%). Eight patients (4.8%)developed recurrences. Using univariate analysis, age>50 years, the tumor grade, and LVSI were found to relate to recurrence-free survival (P < 0.05). LVSI was associated with other prognostic factors such as old age, a higher tumor grade, and deeper myometrial invasion. But multivariate analysis showed no signifi cance. LVSI was not an independent factor to predict recurrence (P = 0.093). Conclusion LVSI was associated with an increased likelihood of recurrence via univariate analysis in patients with uterine-confined endometrioid endometrial cancer. Multivariate analysis showed no statistical signifi cance. The presence of LVSI seems to have no effect, in and of itself, to alter the treatment plan or to predict the prognosis.