Impact of lympho-vascular space invasion on tumor characteristics and survival outcome of women with low-grade serous ovarian carcinoma

J Surg Oncol. 2018 Feb;117(2):236-244. doi: 10.1002/jso.24801. Epub 2017 Aug 8.

Abstract

Background and objectives: To examine association of lympho-vascular space invasion (LVSI) with clinico-pathological factors and to evaluate survival of women with low-grade serous ovarian carcinoma containing areas of LVSI.

Methods: This is a multicenter retrospective study examining consecutive cases of surgically treated stage I-IV low-grade serous ovarian carcinoma (n = 178). Archived histopathology slides for the ovarian tumors were reviewed, and LVSI was scored as present or absent. LVSI status was correlated to clinico-pathological findings and survival outcome.

Results: LVSI was seen in 79 cases (44.4%, 95% confidence interval [CI] 37.1-51.7). LVSI was associated with increased risk of omental metastasis (87.0% vs 64.9%, odds ratio [OR] 3.62, P = 0.001), high pelvic lymph node ratio (median 12.9% vs 0%, P = 0.012), and malignant ascites (49.3% vs 32.6%, OR 2.01, P = 0.035). On multivariable analysis, controlling for age, stage, and cytoreductive status, presence of LVSI in the ovarian tumor remained an independent predictor for decreased progression-free survival (5-year rates 21.0% vs 35.7%, adjusted-hazard ratio 1.57, 95%CI 1.06-2.34, P = 0.026). LVSI was significantly associated with increased risk of recurrence in lymph nodes (OR 2.62, 95%CI 1.08-6.35, P = 0.047).

Conclusion: LVSI in the ovarian tumor is associated with adverse clinico-pathological characteristics and decreased progression-free survival in women with low-grade serous ovarian carcinoma.

Keywords: low-grade serous; lymphovascular space invasion; ovarian cancer.

MeSH terms

  • Adult
  • Cystadenocarcinoma, Serous / mortality*
  • Cystadenocarcinoma, Serous / pathology
  • Cystadenocarcinoma, Serous / surgery
  • Cytoreduction Surgical Procedures / mortality*
  • Female
  • Follow-Up Studies
  • Humans
  • Lymph Node Excision
  • Lymph Nodes / pathology*
  • Lymph Nodes / surgery
  • Lymphatic Vessels / pathology*
  • Lymphatic Vessels / surgery
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Recurrence, Local / mortality*
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / surgery
  • Ovarian Neoplasms / mortality*
  • Ovarian Neoplasms / pathology
  • Ovarian Neoplasms / surgery
  • Prognosis
  • Retrospective Studies
  • Survival Rate