Table 3. Five-year recurrence rate in endometrial cancer patients with and without LVSI stratified for FIGO stages and histological types (endometrioid/non-endometrioid), risk groups, LN-negative risk groups.
| Variables | LVSI of known status | Unknown status | Recurrence rates actuarial | All Locoregional actuarial | All non-locoregional actuarial | Pelvic/paraaortic LN actuarial | Non-local LN actuarial | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| No LVSI | LVSI | HR (95% CI)‡ | No LVSI | LVSI | HR (95% CI)‡ | No LVSI | LVSI | HR (95% CI)‡ | No LVSI | LVSI | HR (95% CI)‡ | No LVSI | LVSI | HR (95% CI)‡ | ||||
| All stages | 18.7 (632/3,377) | 22.9 | 10.2 | 39.0 | 2.1* (1.8–2.6) | 7.2 | 24.3 | 2.1* (1.6–2.7) | 5.8 | 31.8 | 2.6* (2.0–3.3) | 3.2 | 19.4 | 2.5* (1.8–3.5) | 1.3 | 9.0 | 2.9* (1.7–5.0) | |
| FIGO stages | ||||||||||||||||||
| Stage I | 11.2 (306/2,731) | 20.3 | 8.5 | 25.5 | 2.3* (1.7–3.0) | 6.2 | 17.1 | 2.3* (1.6–3.3) | 4.2 | 19.4 | 3.1* (2.2–4.5) | 2.3 | 8.8 | 2.4* (1.4–4.1) | 1.0 | 5.9 | 4.2* (2.0–8.8) | |
| Stage II | 31.4 (94/299) | 35.1 | 18.0 | 37.0 | 2.3* (1.4–3.7) | 14.8 | 25.9 | 1.9† (1.1–3.4) | 11.6 | 26.7 | 2.4† (1.3–4.4) | 9.6 | 16.3 | 1.6 (0.8–3.5) | 1.6 | 6.7 | 3.5 (0.8–15.9) | |
| Stage IIIA/B | 62.7 (116/185) | 30.2 | 37.7 | 55.0 | 1.7† (1.0–2.8) | 23.9 | 31.0 | 1.4 (0.7–2.7) | 32.4 | 45.1 | 1.6 (0.9–2.8) | 13.4 | 32.4 | 2.9† (1.2–6.9) | 9.7 | 14.6 | 1.1 (0.3–3.8) | |
| Stage IIIC | 74.1 (100/135) | 26.2 | 17.6 | 60.8 | 5.0* (2.1–11.7) | 2.9 | 39.4 | 17.1† (2.3–127) | 17.6 | 56.6 | 4.4* (1.8–10.4) | 8.9 | 40.7 | 6.4† (1.9–22.0) | 2.9 | 15.1 | 5.6 (0.7–47.2) | |
| Stage IV | 59.3 (16/27) | 40.0 | 49.4 | 55.0 | 2.6 (0.6–10.4) | 14.3 | 31.0 | 4.8 (0.2–123) | 40.6 | 50.9 | 2.4 (0.6–10.3) | 14.3 | 36.5 | 17.9 (0.6–521) | 14.3 | 15.4 | 2.3 (0.1–36.0) | |
| Endometrioid | 17.1 (521/3,051) | 22.8 | 8.8 | 35.4 | 2.4* (1.9–3.0) | 6.6 | 23.3 | 2.2* (1.7–2.9) | 4.2 | 27.3 | 3.1* (2.3–4.2) | 2.4 | 16.5 | 2.9* (1.9–4.3) | 0.9 | 7.5 | 3.7* (1.9–7.2) | |
| Non-endometrioid | 34.1 (111/326) | 23.8 | 27.5 | 56.7 | 1.6† (1.1–2.5) | 13.8 | 29.8 | 1.9† (1.0–3.5) | 24.3 | 53.4 | 1.6† (1.1–2.6) | 13.0 | 34.6 | 2.0† (1.1–3.7) | 6.0 | 17.4 | 2.0 (0.7–5.3) | |
| Stage I risk groups | ||||||||||||||||||
| Low-risk | 5.6 (98/1,756) | 21.9 | 5.8 | 13.7 | 2.4† (1.3–4.3) | 4.9 | 10.8 | 2.2† (1.1–4.3) | 2.1 | 8.7 | 4.2* (1.9–9.1) | 1.1 | 2.3 | 1.9 (0.4–8.1) | 0.5 | 3.3 | 6.4† (1.7–24.2) | |
| Intermediate-risk | 20.4 (147/720) | 17.5 | 11.6 | 28.1 | 2.9* (1.9–4.4) | 8.4 | 19.6 | 2.8* (1.7–4.6) | 5.4 | 20.1 | 4.5* (2.6–7.9) | 3.1 | 11.6 | 4.4* (2.1–9.1) | 1.4 | 4.8 | 3.7† (1.1–11.9) | |
| High-risk | 23.9 (61/255) | 16.7 | 22.6 | 39.8 | 1.6 (0.9–2.9) | 11.1 | 21.5 | 1.8 (0.8–4.0) | 19.4 | 36.8 | 1.9† (1.0–3.4) | 10.1 | 13.3 | 1.1 (0.4–3.1) | 4.2 | 15.9 | 3.4 (0.9–12.1) | |
| Stage I LN negative | ||||||||||||||||||
| Intermediate-risk | 23.6 (68/288) | 20.0 | 11.5 | 27.2 | 2.7* (1.6–5.9) | 7.8 | 20.0 | 3.0† (1.4–6.6) | 6.0 | 17.8 | 3.4† (1.4–8.2) | 4.5 | 13.3 | 3.9† (1.4–10.9) | 2.1 | 1.9 | 0.4 (0.04–4.2) | |
| High-risk | 17.2 (28/163) | 16.4 | 22.5 | 39.5 | 1.5 (0.7–3.1) | 10.4 | 17.6 | 1.4 (0.4–4.7) | 20.0 | 36.1 | 1.6 (0.7–3.6) | 10.4 | 13.4 | 1.1 (0.3–4.0) | 3.5 | 15.4 | 4.9 (0.9–27.1) | |
Values are presented as number (%). Recurrences divided into locoregional (vaginal/pelvic), non-locoregional including (abdominal/distant recurrences). LN recurrences furthermore divided into pelvic/paraaortic and non-local LN recurrences (inguinal/extra abdominal LN).
CI, confidence interval; FIGO, International Federation of Gynecology and Obstetrics; HR, hazard ratio; LN, lymph node; LVSI, lymph-vascular space invasion.
*The p<0.001; †The p<0.05 LVSI against no LVSI by adjusted Cox analysis; ‡HR (95% CI) for Cox adjusted for unknown LVSI status, age (20–59, 60–69, 70–79, and over 80), American Society of Anesthesiologists (1, 2, 3–5, and unknown), stage, grade (grade I, II, III, serous, clear, and undifferentiated), LN resection and adjuvant therapy with external beam radiation therapy (yes/no), or chemo (yes/no) as categorical parameters. One hundred and thirty-six patients with progression excluded from analysis of recurrences.