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Pseudovascular Invasion: Minimally Invasive Surgery for Endometrial Cancer

BACKGROUND AND OBJECTIVES: To determine if the use of an intrauterine manipulator is associated with an increased incidence of pseudovascular invasion on pathologic evaluation of hysterectomy specimens for endometrial cancer and to assess the possible implications of pseudovascular space invasion in...

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Autores principales: Seifi, Farinaz, Parkash, Vinita, Clark, Mitchell, Menderes, Gulden, Tierney, Christina, Silasi, Dan-Arin, Azodi, Masoud
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Society of Laparoendoscopic Surgeons 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6596444/
https://www.ncbi.nlm.nih.gov/pubmed/31285650
http://dx.doi.org/10.4293/JSLS.2019.00021
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author Seifi, Farinaz
Parkash, Vinita
Clark, Mitchell
Menderes, Gulden
Tierney, Christina
Silasi, Dan-Arin
Azodi, Masoud
author_facet Seifi, Farinaz
Parkash, Vinita
Clark, Mitchell
Menderes, Gulden
Tierney, Christina
Silasi, Dan-Arin
Azodi, Masoud
author_sort Seifi, Farinaz
collection PubMed
description BACKGROUND AND OBJECTIVES: To determine if the use of an intrauterine manipulator is associated with an increased incidence of pseudovascular invasion on pathologic evaluation of hysterectomy specimens for endometrial cancer and to assess the possible implications of pseudovascular space invasion in the treatment of endometrial cancer. METHODS: We performed a retrospective cohort study of patients with early stage (I/II) endometrial cancer who underwent minimally invasive surgical staging. The following data were abstracted: race, body mass index, grade, age, stage, histology, presence or absence of lymphovascular space invasion (LVSI), peritoneal cytology, and adjuvant treatment. Slides were blindly reviewed by a gynecologic pathologist. RESULTS: Of the104 patients meeting eligibility criteria, 74 cases were reviewed in detail (the study was terminated early based on the results of an interim analysis). Patients in the no-manipulator group were older (P = .02) and had a higher stage 1B/II (P = .01) than patients in the manipulator group. No difference was found in the incidence of pseudovascular invasion between the manipulator and the no-manipulator groups (P = .86). Subgroup analysis showed no association of pseudovascular invasion with tumor grade (P = .79). Five patients were identified to have pseudovascular invasion misdiagnosed as true LVSI—4 had endometrioid and 1 had serous histology. Of these, 3 were in the manipulator group. Two received adjuvant radiotherapy which they not have gotten, absent reported lymphovascular invasion. CONCLUSION: The use of a uterine manipulator does not appear to increase the rate of pseudovascular invasion in our limited data set. Misdiagnosis of pseudovascular invasion as LVSI can result in risk migration of patients with potential for harm from unwarranted adjuvant therapy.
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spelling pubmed-65964442019-07-08 Pseudovascular Invasion: Minimally Invasive Surgery for Endometrial Cancer Seifi, Farinaz Parkash, Vinita Clark, Mitchell Menderes, Gulden Tierney, Christina Silasi, Dan-Arin Azodi, Masoud JSLS Research Article BACKGROUND AND OBJECTIVES: To determine if the use of an intrauterine manipulator is associated with an increased incidence of pseudovascular invasion on pathologic evaluation of hysterectomy specimens for endometrial cancer and to assess the possible implications of pseudovascular space invasion in the treatment of endometrial cancer. METHODS: We performed a retrospective cohort study of patients with early stage (I/II) endometrial cancer who underwent minimally invasive surgical staging. The following data were abstracted: race, body mass index, grade, age, stage, histology, presence or absence of lymphovascular space invasion (LVSI), peritoneal cytology, and adjuvant treatment. Slides were blindly reviewed by a gynecologic pathologist. RESULTS: Of the104 patients meeting eligibility criteria, 74 cases were reviewed in detail (the study was terminated early based on the results of an interim analysis). Patients in the no-manipulator group were older (P = .02) and had a higher stage 1B/II (P = .01) than patients in the manipulator group. No difference was found in the incidence of pseudovascular invasion between the manipulator and the no-manipulator groups (P = .86). Subgroup analysis showed no association of pseudovascular invasion with tumor grade (P = .79). Five patients were identified to have pseudovascular invasion misdiagnosed as true LVSI—4 had endometrioid and 1 had serous histology. Of these, 3 were in the manipulator group. Two received adjuvant radiotherapy which they not have gotten, absent reported lymphovascular invasion. CONCLUSION: The use of a uterine manipulator does not appear to increase the rate of pseudovascular invasion in our limited data set. Misdiagnosis of pseudovascular invasion as LVSI can result in risk migration of patients with potential for harm from unwarranted adjuvant therapy. Society of Laparoendoscopic Surgeons 2019 /pmc/articles/PMC6596444/ /pubmed/31285650 http://dx.doi.org/10.4293/JSLS.2019.00021 Text en © 2019 by JSLS, Journal of the Society of Laparoendoscopic Surgeons. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/3.0/us/), which permits for noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited and is not altered in any way.
spellingShingle Research Article
Seifi, Farinaz
Parkash, Vinita
Clark, Mitchell
Menderes, Gulden
Tierney, Christina
Silasi, Dan-Arin
Azodi, Masoud
Pseudovascular Invasion: Minimally Invasive Surgery for Endometrial Cancer
title Pseudovascular Invasion: Minimally Invasive Surgery for Endometrial Cancer
title_full Pseudovascular Invasion: Minimally Invasive Surgery for Endometrial Cancer
title_fullStr Pseudovascular Invasion: Minimally Invasive Surgery for Endometrial Cancer
title_full_unstemmed Pseudovascular Invasion: Minimally Invasive Surgery for Endometrial Cancer
title_short Pseudovascular Invasion: Minimally Invasive Surgery for Endometrial Cancer
title_sort pseudovascular invasion: minimally invasive surgery for endometrial cancer
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6596444/
https://www.ncbi.nlm.nih.gov/pubmed/31285650
http://dx.doi.org/10.4293/JSLS.2019.00021
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