Association between tumor diameter and lymphovascular space invasion among women with early-stage endometrial cancer

Objective: To investigate the association between tumor diameter and intratumoral risk factors thatmight predict the need for full surgical staging among womenwith endometrial cancer (EC). Methods: Data frompatients with early-stage EC treated at the Istituto Nazionale dei Tumori, Milan, Italy, between January 2004 and December 2012 were retrospectively analyzed. Associations between tumor diameter and tumor grade, myometrial invasion, risk group, lymphovascular space invasion (LVSI), and lower uterine segment (LUS) involvement were assessed by bivariate and multivariate analysis. Results: In total, 181 patients met the inclusion criteria. The tumor diameterwas 2 cmor less in 110 women (60%). χ² analysis showed that tumor grading,myometrial invasion, risk group, and LVSI were significantly associated with tumor size (P <0.001), whereas LUS involvement was marginally associated (P = 0.051). By multivariate analysis, LVSI and myometrial invasion had an independent association with tumor size greater than 2 cm (P <0.018). Conclusion: Tumor size greater than 2 cm was significantly and independently associated with LVSI and myometrial invasion among patients with earlystage EC. Given the difficulty of obtaining reliable LVSI data from frozen sections, tumor size might be used as a surrogate at the time of surgery to provide additional information to triage patients for full surgical staging.