Academic Journal
Preoperative LVSI assessment in early-stage cervical cancer: Can it reliably guide lymph node management?
| Τίτλος: | Preoperative LVSI assessment in early-stage cervical cancer: Can it reliably guide lymph node management? |
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| Συγγραφείς: | Wolswinkel JT; Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Postbus 9101, 6500, HB, Nijmegen, the Netherlands; Department of Gynaecology and Obstetrics, Maastricht University Medical Centre (MUMC+), P. Debyelaan 25, 6229, HX, Maastricht, the Netherlands. Electronic address: janneke.wolswinkel@radboudumc.nl., Bekkers AHPA; Department of Gynaecological Oncology, University Medical Centre Utrecht, Utrecht Cancer Centre, 3508, GA, Utrecht, the Netherlands., Maurits JSF; Radboud University Medical Centre, IQ Health science department, Postbus 9101, 6500, HB, Nijmegen, the Netherlands., Bekkers RLM; Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Postbus 9101, 6500, HB, Nijmegen, the Netherlands; Department of Obstetrics and Gynaecology, Medical Centre and GROW School for Oncology and Reproduction, Maastricht University, Universiteitssingel 40, 6229, ER, Maastricht, the Netherlands., Simons M; Department of Pathology, Radboud University Medical Centre, Postbus 9101, 6500, HB, Nijmegen, the Netherlands., Siebers AG; Palga, the Dutch Nationwide Pathology Databank, De Bouw 123 3991, SZ, Houten, the Netherlands., Zusterzeel PLM; Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Postbus 9101, 6500, HB, Nijmegen, the Netherlands., Ten Eikelder MLG; Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Postbus 9101, 6500, HB, Nijmegen, the Netherlands. |
| Πηγή: | Gynecologic oncology [Gynecol Oncol] 2026 Jul; Vol. 210, pp. 106-112. Date of Electronic Publication: 2026 Jun 01. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Academic Press Country of Publication: United States NLM ID: 0365304 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1095-6859 (Electronic) Linking ISSN: 00908258 NLM ISO Abbreviation: Gynecol Oncol Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: New York, Academic Press. |
| Ιατρικοί όροι (MeSH): | Uterine Cervical Neoplasms*/pathology , Uterine Cervical Neoplasms*/surgery , Uterine Cervical Neoplasms*/mortality , Lymph Nodes*/pathology , Lymph Nodes*/surgery, Lymphatic Metastasis/pathology ; Humans ; Female ; Neoplasm Staging ; Retrospective Studies ; Middle Aged ; Adult ; Lymph Node Excision ; Neoplasm Invasiveness ; Aged |
| Περίληψη: | Objective: Lymph vascular space invasion (LVSI) is important in the management of early-stage cervical cancer. This study evaluated whether preoperative LVSI predicts final LVSI status and lymph node metastases (LNM), and the impact of LVSI discordance on overall survival (OS). Methods: In this nationwide retrospective cohort study, patients diagnosed between 2000 and 2024 with FIGO 2018 stages IA1-IB2 squamous, adeno-, or adenosquamous cervical carcinoma were included. Patients were classified into a biopsy-group (biopsy only prior to definitive surgery) or an excision-group (Large Loop Excision of the Transformation Zone (LLETZ) and/or conization (with or without biopsy first)) prior to surgery. Results: In total, 2136 patients were included in the biopsy-group and 547 in the excision-group. In the biopsy-group, 40.3% of patients with preoperative LVSI-negative status was LVSI-positive on final pathology, yielding an Negative Predictive Value (NPV) of 55.8%, compared with 24.8% in the excision-group (NPV 71.0%). Among patients with FIGO 2018 stage IA1-IA2 disease, the risk of LNM was low (2.3%), including those with discordant LVSI status (1.7%). Five-year OS rates exceeded 94% across all LVSI categories for both IA1 and IA2 stages. Conclusion: Preoperative LVSI assessment has limited reliability in predicting final LVSI status, particularly when based on biopsy alone. Nevertheless, patients with FIGO IA1-IA2 cervical cancer and preoperative LVSI-negative status demonstrate low risks of LNM and excellent survival outcomes. Preoperative excision by LLETZ or conization improves diagnostic accuracy, informs FIGO staging and supports more informed surgical decision-making. (Copyright © 2026 The Authors. Published by Elsevier Inc. All rights reserved.) |
| Competing Interests: | Declaration of competing interest There were no conflicts of interested stated by authors. |
| Contributed Indexing: | Keywords: Cervical cancer; Diagnostic accuracy; Lymph node metastasis; Lymph vascular space invasion |
| Entry Date(s): | Date Created: 20260601 Date Completed: 20260717 Latest Revision: 20260717 |
| Update Code: | 20260718 |
| DOI: | 10.1016/j.ygyno.2026.05.025 |
| PMID: | 42224889 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1095-6859 |
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| DOI: | 10.1016/j.ygyno.2026.05.025 |