Lymphovascular space involvement in early stage well-differentiated endometrial cancer is associated with increased mortality

Objective  To study the relationship between lymphovascular space involvement (LVSI) in stage 1a or 1b well-differentiated endometrial cancer and survival.
Design  Retrospective study consisting of a search of an oncology database to identify women with endometrial cancer between January 1990 and December 2004.
Setting  Tertiary referral centre, Dublin, Ireland.
Sample  Women who had well-differentiated stage 1a or 1b endometrial cancer.
Methods  During the period 1990–2004, 226 patients with endometrial cancer were treated in the National Maternity Hospital, Dublin. We looked at all patients who had well-differentiated endometrioid adenocarcinoma of the endometrium with invasion of <50% thickness of the myometrium. Forty-one patients fulfilled these inclusion criteria. The presence or absence of LSVI was determined by review of haematoxylin and eosin sections. Patients were followed for 5 years or till death if earlier. Mortality was calculated. Statistical analysis was performed using Fisher's exact test. An odds ratio and 95% confidence interval was calculated using fixed effect Mantel–Haenszel model.
Main outcome measures  Death from recurrence of endometrial cancer.
Results  Of the 41 patients, five (12%) were found to have (LVSI). Of the five patients with LVSI, three (60%) patients died of recurrence. All patients with recurrence died of disease and none of the patients without LVSI died (0 of 36). Overall, the survival rate was 92.7%. The presence of LVSI was a highly significant predictor of recurrence ( P  < 0.001).
Conclusion  In patients with early stage well-differentiated adenocarcinoma of the endometrium, the presence of LVSI is associated with a high risk of death.