Middle East Journal of Cancer

The Prognostic Significance of LVSI in Early-Stage Endometrioid Endometrial Cancer: Insights into Recurrence Patterns and Survival Outcomes

Document Type : Original Article(s)

Authors

Fatemeh Sadat Najib 1, 2
Parisa Yazdanshenas 1
Mojgan Akbarzadeh Jahromi 1, 3
Zahra Shiravani 3, 4

1 Department of Obstetrics and Gynecology, Shiraz University of Medical Sciences, Shiraz, Iran

2 Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

3 Department of Obstetrics and Gynecology, Division of Oncology Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

4 Maternal-Fetal Medicine Research Center, Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

https://doi.org/10.30476/mejc.2026.105882.2252
Abstract
Background: Endometrioid endometrial cancer (EEC) is a significant disease among women worldwide. The present study aimed to investigate the role of lymphovascular space invasion (LVSI) detection in recurrence and survival rates in patients with early-stage (stage I) EEC.
Method: This retrospective study included 234 patients diagnosed with stage I EEC. Considering the demographic information and EEC history, we evaluated the presence of LVSI and its association with recurrence rate, overall survival, and recurrence-free survival. Kaplan-Meier analysis was used to compare survival outcomes between patients with and without LVSI. Statistical analyses were conducted using SPSS software (version 22.0; IBM Corporation, USA). Kaplan-Meier analysis and log-rank tests were used for survival analysis, and P < 0.05 was considered to be significant.
Results: Of 234 patients, 17 relapsed and 8 died. The average time to recurrence was approximately 2.5 years, with vaginal recurrence being the most common. LVSI was identified in 7 patients and was associated with poorer overall survival, but did not predict recurrence-free survival. Patients with LVSI showed a higher risk of recurrence and shorter survival intervals. Stage IA patients with LVSI had relatively high survival probability, while stage IB (myometrial invasion ≥ 50%) patients with LVSI had much poorer outcomes.
Conclusion: LVSI is a critical prognostic factor in early-stage EEC, significantly affecting overall survival. Our study highlights the importance of advanced surveillance and more aggressive treatment for LVSI-positive patients, especially in stage IB. Standardized LVSI assessment and further research are essential to optimize patient management.

Highlights

Zahra Shiravani (google scholar)

Keywords

Endometrial neoplasms
Neoplasm recurrence
Survival rate
Prognosis
LVSI
Subjects

Please cite this article as:

Najib FS, Yazdanshenas P, Akbarzadeh Jahromi M, Shiravani Z. The prognostic significance of LVSI in early-stage endometrioid endometrial Cancer: Insights into recurrence patterns and survival outcomes. Middle East J Cancer. 2026;17(4):354-63. doi:10.30476/mejc.2026.105882.2252.

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