LYMPHVASCULAR SPACE INVOLVEMENT - A PROGNOSTIC INDICATOR IN PATIENTS WITH SURGICAL STAGE-I ENDOMETRIAL ADENOCARCINOMA TREATED WITH POSTOPERATIVE RADIATION

The objective of this study was to evaluate the prognostic indices of lymphvascular space involvement (LVS), surgical substage and grade on recurrence and survival in patients with surgical stage I endometrial adenocarcinoma, who had received postoperative external beam radiation (ERT). The medical records of all patients who had surgical stage I e ndometrial cancer between January 1987 and December 1991 were reviewed . Prognostic indicators, ie LVS, surgical substage and grade were corr elated with recurrence and survival by log-rank test. Recurrence and s urvival distributions were estimated using the product limit method. O ne hundred and twenty-two patients had surgical stage I endometrial ca ncer. Eight patients were excluded because of histologic types other t han endometrioid adenocarcinoma. An additional 27 patients were exclud ed since they had surgical stage IA and grade 1 and had not received E RT. The remaining 87 patients who had surgical stage IB and IC and who had received ERT, are the focus of this study. Ten patients had recur rences, all of which were outside the prescribed field of radiation. N ine of 11 (82%) patients with LVS recurred and 8/11 (73%) patients wit h LVS died of disease (P = 0.0001). Surgical substage did not correlat e with risk for recurrence (P < 0.51). Five-year survival for the stud y group was 92%. LVS correlated well with survival (P < 0.0001), while grade and surgical substage were not significant indicators of surviv al in these patients, with surgically documented early disease (P > 0. 13 and P > 0.57). LVS appears to be an important prognostic indicator for both recurrence and survival in patients with surgical stage I end ometrial adenocarcinoma who receive postoperative ERT.