Extent of Lymphovascular Space Invasion and Risk of Pelvic Lymph Node Metastases in Stage IB1 Cervical Cancer
Anchalee Chandacham MD*, Kittipat Charoenkwan MD*, Sumalee Siriaunkgul MD**, Jatupol Srisomboon MD*, Prapaporn Suprasert MD*, Chailert Phongnarisorn MD*, Chalong Cheewakraingkrai MD*, Sitthicha Siriaree MD*, Charuwan Tantipalakorn MD*, Chumnan Kietpeerakool MD*
Affiliation : * Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai ** Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai
Objective : To evaluate whether the extent of lymphovascular space invasion (LVSI) is a risk factor for pelvic
lymph node metastases in stage IB1 cervical cancer.
Materials and Methods : The clinicopathological data of 397 patients with stage IB1 cervical cancer undergo-
ing radical hysterectomy and pelvic lymphadenectomy (RHPL) at Chiang Mai University Hospital between
January 1998 and December 2002 were analyzed. The histology, tumor grade, depth of stromal invasion,
uterine corpus involvement, parametrial invasion and LVSI were analyzed for their association with pelvic
node metastases. The extent of LVSI was classified as negative, minimal (< 10 LVSI / cervical specimen), and
extensive (> 10 LVSI / cervical specimen).
Results : Of the 397 patients, 146 (36.8%) had tumors containing LVSI, 82 (20.7%) and 64 (16.1%) had
minimal and extensive LVSI, respectively. Fifty nine (14.9%) patients had pelvic node metastases. Using
multivariable analysis, LVSI (p < 0.001), depth of stromal invasion (p < 0.001), tumor grade (p < 0.001), and
parametrial invasion (p < 0.001) were significant predictors of pelvic node metastases. The extent of LVSI
either minimal or extensive degree significantly influenced pelvic node metastases.
Conclusion : The presence of LVSI especially extensive involvement was significantly associated with the risk
of pelvic node metastases in stage IB1 cervical cancer.
Keywords : Lymphovascular space invasion, Pelvic node metastases, Cervical cancer
