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Lymphovascular spac...
Lymphovascular space invasion as a predictive factor for lymph node metastases and survival in endometrioid endometrial cancer - a Swedish Gynecologic Cancer Group (SweGCG) study
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Stalberg, K. (author)
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Bjurberg, M. (author)
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Borgfeldt, C. (author)
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Carlson, J. (author)
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- Dahm-Kähler, Pernilla, 1964 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för obstetrik och gynekologi,Institute of Clinical Sciences, Department of Obstetrics and Gynecology
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Floter-Radestad, A. (author)
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Hellman, K. (author)
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Hjerpe, E. (author)
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Holmberg, E. (author)
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Kjolhede, P. (author)
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Marcickiewicz, J. (author)
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Rosenberg, P. (author)
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Tholander, B. (author)
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Avall-Lundqvist, E. (author)
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Hogberg, T. (author)
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(creator_code:org_t)
- 2019-08-02
- 2019
- English.
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In: Acta Oncologica. - : Informa UK Limited. - 0284-186X .- 1651-226X. ; 58:11, s. 1628-1633
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https://www.tandfonl...
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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Abstract
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- Background: The aim of this study is to evaluate the impact of lymphovascular space invasion (LVSI) on the risk of lymph node metastases and survival in endometrioid endometrial adenocarcinoma. Material and methods: As regard the study design, this is a cohort study based on prospectively recorded data. Patients with endometrioid endometrial adenocarcinoma registered in the Swedish Quality Registry for Gynecologic Cancer 2010-2017 with FIGO stages I-III and verified nodal status were identified (n = 1587). LVSI together with established risk factors, namely DNA ploidy, FIGO grade, myometrial invasion and age, were included in multivariable regression analyses with lymph node metastases as the dependent variable. Associations between the risk factors and overall and relative survival were included in multivariable models. Estimates of risk ratios (RR), hazard ratios (HR), excess mortality rate ratios (EMR), and 95% confidence intervals (95% CI) were calculated. Results: The presence of LVSI presented the strongest association with lymph node metastases (RR = 5.46, CI 3.69-8.07, p < .001) followed by deep myometrial invasion (RR = 1.64, CI 1.13-2.37). In the multivariable survival analyses, LVSI (EMR = 7.69, CI 2.03-29.10,) and non-diploidy (EMR = 3.23, CI 1.25-8.41) were associated with decreased relative survival. In sub-analyses including only patients with complete para-aortic and pelvic lymphadenectomy and negative lymph nodes (n = 404), only LVSI (HR = 2.50, CI 1.05-5.98) was associated with a worsened overall survival. Conclusion: This large nationwide study identified LVSI as the strongest independent risk factor for lymph node metastases and decreased survival in patients with endometrioid adenocarcinomas. Moreover, decreased overall survival was also seen in patients with LVSI-positive tumors and negative lymph nodes, indicating that hematogenous dissemination might also be important.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
Keyword
- risk-factors
- prognostic-factors
- involvement
- recurrence
- register
- patterns
- disease
- depth
- women
- lvsi
- Oncology
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Stalberg, K.
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Bjurberg, M.
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Borgfeldt, C.
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Carlson, J.
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Dahm-Kähler, Per ...
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Floter-Radestad, ...
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show more...
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Hellman, K.
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Hjerpe, E.
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Holmberg, E.
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Kjolhede, P.
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Marcickiewicz, J ...
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Rosenberg, P.
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Tholander, B.
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Avall-Lundqvist, ...
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Hogberg, T.
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cancer and Oncol ...
- Articles in the publication
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Acta Oncologica
- By the university
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University of Gothenburg