Abstract：
The 2020 ESGO/ESTRO/ESP guidelines stratify the prognosis of endometrial carcinoma (EC) patients combining The Cancer Genome ATLAS (TCGA) molecular signature and pathological factors, including lymphovascular space invasion (LVSI). However, little is known about the prognostic independence of LVSI from molecular signature.
To assess whether the prognostic value of LVSI is independent from the TCGA signature.
A systematic review and meta-analysis was performed by searching 5 electronic databases from their inception to March 2021. All peer-reviewed studies reporting assessing LVSI as a prognostic factor independent from the TCGA groups in EC were included. Multivariate HRs with 95% confidence interval (CI) were pooled separately for overall survival (OS), disease-specific survival (DSS) and disease-free survival (DFS). The absence of LVSI was considered as a reference. In DFS analyses, locoregional and distant recurrence were separately considered for one study.
Six studies with 3331 patients were included in the systematic review and three studies with 2276 patients in the meta-analysis. LVSI showed a pooled multivariate HR of 1.818 (CI 95%, 1.378-2.399) for OS, 1.849 (CI 95%, 1.194-2.863) for DSS, 1.377 (CI 95%, 1.008-1.880) for DFS excluding one study, 1.651 (CI 95%, 1.044-2.611) for DFS additionally considering locoregional recurrence from one study, and 1.684 (CI 95%, 1.05-2.701) for DFS additionally considering distant recurrence from the same study.
LVSI has a prognostic value independent of TCGA signature, as well as age and adjuvant treatment, increasing the risk of death of any cause, death due to EC and recurrent or progressive disease by 1.5-2 times.
To assess whether the prognostic value of LVSI is independent from the TCGA signature.
A systematic review and meta-analysis was performed by searching 5 electronic databases from their inception to March 2021. All peer-reviewed studies reporting assessing LVSI as a prognostic factor independent from the TCGA groups in EC were included. Multivariate HRs with 95% confidence interval (CI) were pooled separately for overall survival (OS), disease-specific survival (DSS) and disease-free survival (DFS). The absence of LVSI was considered as a reference. In DFS analyses, locoregional and distant recurrence were separately considered for one study.
Six studies with 3331 patients were included in the systematic review and three studies with 2276 patients in the meta-analysis. LVSI showed a pooled multivariate HR of 1.818 (CI 95%, 1.378-2.399) for OS, 1.849 (CI 95%, 1.194-2.863) for DSS, 1.377 (CI 95%, 1.008-1.880) for DFS excluding one study, 1.651 (CI 95%, 1.044-2.611) for DFS additionally considering locoregional recurrence from one study, and 1.684 (CI 95%, 1.05-2.701) for DFS additionally considering distant recurrence from the same study.
LVSI has a prognostic value independent of TCGA signature, as well as age and adjuvant treatment, increasing the risk of death of any cause, death due to EC and recurrent or progressive disease by 1.5-2 times.
摘要：
2020年ESGO/ESTRO/ESP指南结合癌症基因组ATLAS（TCGA）分子特征和病理因素对子宫内膜癌（EC）患者的预后进行了分层，包括淋巴管间隙侵犯（LVSI）。然而,关于LVSI与分子特征的预后独立性知之甚少.
评估LVSI的预后价值是否独立于TCGA特征。
从成立到2021年3月，通过搜索5个电子数据库进行了系统评价和荟萃分析。纳入了所有同行评审的研究，这些研究报告评估LVSI是独立于EC中TCGA组的预后因素。将具有95%置信区间(CI)的多变量HR分别合并为总生存期(OS)。疾病特异性生存率（DSS）和无病生存率（DFS）。不存在LVSI被认为是参考。在DFS分析中，一项研究分别考虑局部复发和远处复发.
系统评价中纳入了6项3331例患者的研究，meta分析中纳入了3项2276例患者的研究。LVSI显示汇总的多变量HR为1.818(CI95%，1.378-2.399)适用于操作系统，1.849（CI95%，1.194-2.863)对于DSS，1.377（CI95%，1.008-1.880)对于不包括一项研究的DFS，1.651（CI95%，1.044-2.611)对于DFS，还考虑了一项研究的局部复发，和1.684（CI95%，1.05-2.701）用于DFS，另外考虑同一研究的远处复发。
LVSI具有独立于TCGA特征的预后价值，以及年龄和辅助治疗，增加任何原因的死亡风险，因EC死亡和复发或进行性疾病1.5-2倍。
评估LVSI的预后价值是否独立于TCGA特征。
从成立到2021年3月，通过搜索5个电子数据库进行了系统评价和荟萃分析。纳入了所有同行评审的研究，这些研究报告评估LVSI是独立于EC中TCGA组的预后因素。将具有95%置信区间(CI)的多变量HR分别合并为总生存期(OS)。疾病特异性生存率（DSS）和无病生存率（DFS）。不存在LVSI被认为是参考。在DFS分析中，一项研究分别考虑局部复发和远处复发.
系统评价中纳入了6项3331例患者的研究，meta分析中纳入了3项2276例患者的研究。LVSI显示汇总的多变量HR为1.818(CI95%，1.378-2.399)适用于操作系统，1.849（CI95%，1.194-2.863)对于DSS，1.377（CI95%，1.008-1.880)对于不包括一项研究的DFS，1.651（CI95%，1.044-2.611)对于DFS，还考虑了一项研究的局部复发，和1.684（CI95%，1.05-2.701）用于DFS，另外考虑同一研究的远处复发。
LVSI具有独立于TCGA特征的预后价值，以及年龄和辅助治疗，增加任何原因的死亡风险，因EC死亡和复发或进行性疾病1.5-2倍。
