Preoperative lymph-vascular space invasion is associated with nodal metastases in women with early-stage cervical cancer

Objective. To determine the association between findings on review of preoperative biopsy specimens and the risk of lymph node involvement (LNI) at radical hysterectomy in patients with early-stage cervical cancer. Methods. Eighty-one patients were included in this retrospective review. Preoperative biopsy features evaluated were stage, grade, histologic subtype, lymph-vascular space invasion (LVSI), and depth (>4 mm) of invasion. Results. Twelve patients (14.8%) had LNI at radical hysterectomy. Stage, grade, and histologic subtype were not associated with LNI. LVSI and depth of invasion >4 mm were both significantly associated with LNI (25.6% vs. 4.8%, P= 0.0 1, and 25.0% vs. 4.5%, P= 0.0 1, respectively)- LVSf with >4 mm invasion was 6.6 times more likely to have LNI at the time of radical hysterectomy (RR=6.6; 95% confidence interval, 2.1-21.9). Conclusion. Patients with preoperative LVSI are at higher risk for LNI at radical hysterectomy and should be counseled regarding potential implications for management. (c) 2007 Elsevier Inc. All rights reserved.