Lymphovascular space invasion and positive peritoneal cytology are independent prognostic factors for lymph node metastasis and recurrence in endometrial cancer

Aim: The aim is to identify the risk factors for recurrence and lymphatic metastasis of endometrial cancer. Materials and Methods: Patients who were operated primarily for endometrial cancer between 2010-2016 were included. Parameters such as stage, grade, histology, depth of invasion, cytology status, lymphovascular space invasion (LVSI), and tumor size were recorded. Univariate and multivariate logistic regression models were used to identify pathological predictors of lymphatic dissemination and recurrence. Results: A total of 278 patients were evaluated. Mean age was 60. 80% were Stage I, 10% were Stage III, and 4% were Stage IV, and 36.7% of patients had LVSI. Lymphadenectomy was performed in 56% of patients and lymphatic metastasis was observed in 7.1% of patients. In 13 patients, recurrence occurred; seven were loco-regional and six were distant. Three patients who had recurrence (3/13) were in early stage. With multivariate analysis, LVSI [OR = 8.826;1.874-41.576 (95%CI), p = 0.006] and positive cytology [OR = 9.503;1.811- 49.876 (95%CI), p = 0.008] were independent factors for recurrence in endometrial cancer. Additionally, for lymphatic metastasis, LVSI [OR = 6.195;1.258-30.506 (95%CI), p = 0.025] and positive cytology [OR = 14.258; 2.330-87.247 (95%CI), p = 0.004] were found as significant risk factors. Conclusion: LVSI and positive cytology are significant risk factors for lymphatic metastasis and recurrence in endometrial cancer. Patients who had these risk factors should be followed-up more cautiously in terms of recurrence.

Endometrial cancer; Lymph node; Lymphovascular space invasion; Peritoneal cytology; Recurrence.

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