■评估早期子宫内膜癌(EC)中淋巴血管间隙侵犯(LVSI)的预后意义的研究是相互矛盾的。
■评估在I期EC中确定的LVSI是否与较差的生存率相关。
■对三个数据库(Embase,PubMed,和Cochrane)进行到2023年4月30日。
■纳入了评估I期EC患者LVSI与预后之间关系的队列研究。
■两位作者独立评估了纳入研究,提取复发和生存的数据,并采用随机效应模型进行荟萃分析。通过I2检验评估异质性。
■共有15项研究纳入荟萃分析,涉及6,705名患者。在第一阶段EC中,LVSI的总体合并率为14%[95%置信区间(CI)CI0.09-0.18]。LVSI与较高的复发风险显著相关[比值比(OR)=2.79,95CI2.07-3.77],I期EC患者的总生存期(OS)[风险比(HR)=5.19,95CI3.33-8.07]和无复发生存期(RFS)[HR=5.26,95CI3.45-8.02].同样,LVSI与复发风险增加相关[OR=3.10,95CI2.13-4.51],IA期1级或2级子宫内膜样癌患者的OS[HR=5.52,95CI2.16-14.09]和RFS[HR=4.81,95CI2.34-9.91]降低。
■在阶段IEC和阶段IA中存在LVSI,1级或2级子宫内膜样癌与复发风险增加相关,较低的操作系统和RFS。
■https://www.crd.约克。AC.英国/普华永道/,标识符42023425231。
UNASSIGNED: Studies evaluating the prognostic significance of lymphovascular space invasion (LVSI) in early stage endometrial cancer (EC) are conflicting.
UNASSIGNED: To evaluate whether LVSI identified in stage I EC is associated with worse survival.
UNASSIGNED: A comprehensive literature search of three databases (Embase, PubMed, and Cochrane) was performed up to April 30th 2023.
UNASSIGNED: Cohort studies that have evaluated the relationship between LVSI and prognosis in patients with stage I EC were included.
UNASSIGNED: Two authors independently assessed the studies for inclusion, extracted the data of recurrence and survival, and conducted meta-analysis using random effects model. Heterogeneity was evaluated by I2 test.
UNASSIGNED: A total of 15 studies involving 6,705 patients were included in the meta-analysis. The overall pooled rate of LVSI was 14% [95% confidence interval (CI) CI 0.09-0.18] in stage I EC. LVSI was significantly associated with a higher risk of recurrence [odds ratio (OR) = 2.79, 95%CI 2.07-3.77], reduced overall survival (OS) [hazard ratio (HR)=5.19, 95%CI 3.33-8.07] and recurrence free survival (RFS) [HR = 5.26, 95%CI 3.45-8.02] in stage I EC patients. Similarly, LVSI was associated with an increased risk of recurrence [OR= 3.10, 95%CI 2.13-4.51], decreased OS [HR=5.52, 95%CI 2.16-14.09] and RFS [HR = 4.81, 95%CI 2.34-9.91] in stage IA grade 1 or 2 endometrioid carcinoma patients.
UNASSIGNED: The presence of LVSI in stage I EC and in stage IA, grade 1 or 2 endometrioid carcinoma is associated with an increased risk of recurrence, lower OS and RFS.
UNASSIGNED: https://www.crd.york.ac.uk/prospero/, identifier 42023425231.