The investigation of the factors related to lymphovascular space invasion in endometrium cancer and, the relation between lymphovascular space invasion and myometrial invasion, lower uterus segment involvement, cervical involvement and lymph nodul metastasis

Objective: Having investigated the factors related to lymphovascular space invasion (LVSI) in endometrium cancer and the relations between LVSI and myometrial invasion (MI), lower uterus segment involvement, cervical involvement and lymph nodule metastasis, the purpose of this research is to investigate whether or not LVSI can be used as a new prognostic metric in endometrium cancer. Materials and Methods: 44 patients had gone under hysterectomy + bilateral salpingo-oophorectomy ± pelvic and/or paraaortic lymphadenectomy + omentectomy procedures due to being diagnosed with endometrium cancer between 2015-2021 in our clinic, and according to the pathological results, the patients were divided in to two groups of LVSI positives and negatives. The control group of 29 patients without LVSI and the experimental group of 15 patients with LVSI were identified for the study. The patients were compared according to the analyses done over age, surgery type, gravida, parity, menopause state, malignancy history, malignancy history of family, systematic illnesses, medical drug use, medical operation history, symptomatic complaints, pre-operational endometrial sample analysis results, completed surgeries, pathological diagnosis, surgical stages, pathological results, univariant and multivariant results. Result: The results between the groups were compared according to age, gravida, parity menopause state, malignancy history, malignancy history of family, systematic illnesses, symptomatic complaints, pre-operational endometrial sample analysis results, main material pathology, uterus radius, tumour radius, MI presence, segment involvement of lower uterus, cervical involvement, paraaortic lymph nodule vi involvement, presence of tumour in main material peritoneal cytology and prognosis. According to the statistical analysis no meaningful differences were found (p=0,657, p=0,773, p=0,930, p=0,957, p=0,925, p=0,999, p=0,822, p=0,571, p=0,675, p=0,414, p=0,846, p=0,083, p=0,328 and p<0,05). Two groups were compared with respect to histological grade, nuclear grade, MI depth, pelvic lymph nodule involvement and main material surgical state, and the results were found statistically meaningful. When considered by taking histological and nuclear grade into account, the statistical results showed that the experimental group of patients who had LVSI had a higher rate of grade 3 tumour (p=0,001 and p<0,05). Meaningful statistical results were found with respect to nuclear grade in the LVSI positive patients of the experimental (p=0,001 and p<0,05). Even though no statistically meaningful results were found considering MI presence (p=0,999 and p<0,05), in the presence of MI among the experimental group, the depth of MI is identified to be above ½ (p=0,001 and p<0,05). Likewise, meaningful results were found when the experimental group of LVSI positive patients were considered by taking left and right pelvic nodule involvement into account (for the right pelvic lymph nodule p=0,003 and p<0,005, for the left lymph nodule p=0,001 and p<0,05). Finally, when both groups were compared with respect to the main material surgical staging, it was statistically shown that the LVSI positive patients appeared to have a more mature state of the disease (p=0,009 and p<0,05). Conclusion: Although LVSI's prognostic importance in endometrium cancer was investigated in many research, there is no consensus on its crucial role in the development of endometrium cancer. As a result of our research, we have statistically shown how the presence of LVSI meaningfully impacts histological grade, nuclear grade, MI depth, pelvic lymph nodule involvement and maturity of the disease. Further study with more patients and a longer follow-up period is still needed in this research subject.