INFLUENCE OF QUANTITY OF LYMPH-VASCULAR SPACE INVASION ON THE RISK OFNODAL METASTASES IN WOMEN WITH EARLY-STAGE SQUAMOUS CANCER OF THE CERVIX

Objective. To determine if the quantity of lymph-vascular space invasi on influences the risk of pelvic nodal metastases in women with early- stage cervical squamous carcinoma. Methods. Between 1991 and 1997, 105 women with stages IA2, Ib, and IIa squamous carcinoma of the cervix u nderwent radical hysterectomy and pelvic lymphadenectomy. The histopat hology slides were prospectively reviewed. If lymph-vascular space inv asion (LVSI) was present, the amount was quantified in four ways: perc entage of cervical histopathologic sections containing LVSI, percentag e of sections with tumor containing LVSI, total number of foci of LVSI , and maximal number of foci of LVSI in 10 high-powered fields. These measures of LVSI were correlated with the risk of nodal metastases. Re sults. Seventy-three (70%) women had tumors with LVSI. Of these, 23 ha d pelvic nodal metastases. All women with nodal metastases had tumors with LVSI. Using logistic regession, independent predictors of nodal m etastases were depth of cervical stromal invasion (P = 0.01) and tumor size (P = 0.04). LVSI was also a significant predictor of nodal metas tases based on the Mantel-Haenszel test (P = 0.01). In women whose tum ors contained LVSI, logistic regression identified tumor size (P = 0.0 04) and LVSI in >45% of all cervical histopathologic sections (P = 0.0 02) as significant predictors of nodal metastases. Conclusion. The qua ntity of LVSI, as defined by the percentage of all cervical histopatho logic sections containing LVSI, correlates significantly with the risk of nodal metastases in women with early-stage squamous carcinoma of t he cervix. (C) 1998 Academic Press.