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

ObjectiveTo 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.MethodsEighty-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.ResultsTwelve 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 = 0.01, and 25.0% vs. 4.5%, P = 0.01, respectively). LVSI 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).ConclusionPatients with preoperative LVSI are at higher risk for LNI at radical hysterectomy and should be counseled regarding potential implications for management.