Comparison of lymphovascular space invasion and other prognostic factors in patients operated on for early-stage endometrial cancer

Objective: In this study, it was aimed to investigate the prognostic factors associated with lymphovascular space invasion in Early Stage Endometrial Cancer (Stage 1-2). Methods: In our study, the files of 461 patients who were diagnosed with early stage (Stage 1-2) endometrial cancer in our clinic between 2010 and 2020 and who underwent total hysterectomy, bilateral salpingo-oophorectomy and/or pelvic and/or paraaortic lymphadenectomy in the primary treatment, and whose pathology results were reported as early stage endometrial cancer (Stage 1-2), were scanned. Clinicopathological and demographic characteristics of the patients were evaluated. Patients' age, kilograms, number of births, whether they are postmenopausal, histological type (Type 1, Type 2), histological grade (Grade 1-2-3), myometrial depth (1/2 myometrium exceeded or not), peritoneal cytology taken It was compared whether it was malignant or benign and whether there was lymphovascular invasion. Loess algorithm is used for the relationship between observed outcome and predicted outcome. The distinction between the algorithms was evaluated by calculating the c-index (AUC). Results: In patients with LVSI, advanced age (p=0.006), presence of menopause (p=0.03), Type 2 histological type (p=<0.0001), advanced histological grade (p=<0.0001), preoperative CA 125 values high (p=0.001), malignant abdominal cytology (p=<0.0001), cervical involvement (p=<0.0001), and myometrial depth of the tumor exceeding 1/2 (p=<0.0001). According to our modeling, 3 explanatory variables and LVSI were found to be strongly associated with these factors; myometrial invasion (OR:3.72 0.18-7.6 95% CI), histological grade (OR:1.82 0.11-2.94 95% CI), peritoneal cytology (OR:3.1 0.14-6.48 95% CI). However, weight was not significant (p=0.9), number of births was low or high (p=0.9), presence of diabetes was not significant (p=0.9), presence of hypertension was not significant (p=0.3), preoperative smear ASCUS It was found that it was not significant to be below or above CIN-3 (p=0.5) and when the hpv values were examined, it was found that it was not significant to be positive or negative (p=0.5). Conclusion: It has been observed that there may be a relationship between patients with advanced age, post-menopause period, histologically type 2, preoperative CA 125 level high, presence of cervical involvement and lymphovascular space invasion. It has been observed that there is a strong correlation between patients with lymphovascular space invasion, especially with myometrial depth exceeding ½ myometrium, malignant peritoneal cytology and advanced histological grade. It was concluded that there was no significant difference between patients with and without lymphovascular invasion for systemic diseases (diabetes, hypertension), weight, number of births, preoperative smear and HPV. Keywords: Early stage endometrial cancer, prognostic factors, lymphovascular space invasion