Publication: Impacto de la afectación del espacio linfovascular en el pronóstico del carcinoma de endometrio: factores asociados y estratificación de riesgo
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2018-04-16
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Universidad Complutense de Madrid
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Abstract
El carcinoma de endometrio se constituye como el tumor ginecológico más frecuente en Europa, tras el cáncer de mama. Se considera una enfermedad con un pronóstico favorable cuando se diagnostica en estadios iniciales. Sin embargo, en los casos en los que la enfermedad está diseminada o acontece una recidiva tras el tratamiento primario, el pronóstico se ensombrece claramente. La invasión de los vasos linfáticos y/o sanguíneos por células tumorales (IELV, Invasión del Espacio Linfovascular) se supone uno de los pasos iniciales en el proceso de diseminación tumoral. Su diagnóstico mediante tinción con hematoxilina eosina se ha correlacionado de manera significativa en la literatura con la presencia de metástasis ganglionares, mayores tasas de recidiva tumoral y menores tasas de supervivencia global. No obstante, la IELV está íntimamente relacionada con otras características histológicas consideradas de riesgo en el carcinoma de endometrio, como son el tipo histológico no endometrio de, el grado histológico pobremente diferenciado y la profundidad de la invasión miometrial. En consecuencia, su valor como factor pronóstico independiente en el carcinoma epitelial de endometrio es controvertido, no habiendo sido incluido como parámetro modificador de grupo riesgo durante años en las principales guías de recomendación del manejo clínico de esta entidad nacionales ni internacionales...
Endometrial cancer is the second most frequent gynecological tumor in Europe, after breast cancer. It is considered a disease with good prognosis if diagnosed in initial stages. Nonetheless, in these cases in which disease is disseminated or there is a recurrence after initial treatment, prognosis clearly worsens. Lymphovascular Space Invassion (LVSI) is considered one of the early steps in the tumoral dissemination process. Its diagnosis, by Hemotoxylin and Eosin Staining, has been significantly correlated with the presence of lymph node metastasis, higher recurrence rates and lower survival. However, LVSI is correlated with other prognosis factors of endometrial carcinoma, such as non-endometroid histological type, high tumor grade and the depth of myometrial invasion. As a consequence, its value as an independent prognosis factor of endometrial carcinoma is controversial, not having been included over the last few years as a risk group modifying parameter in the main national or international clinical guidelines...
Endometrial cancer is the second most frequent gynecological tumor in Europe, after breast cancer. It is considered a disease with good prognosis if diagnosed in initial stages. Nonetheless, in these cases in which disease is disseminated or there is a recurrence after initial treatment, prognosis clearly worsens. Lymphovascular Space Invassion (LVSI) is considered one of the early steps in the tumoral dissemination process. Its diagnosis, by Hemotoxylin and Eosin Staining, has been significantly correlated with the presence of lymph node metastasis, higher recurrence rates and lower survival. However, LVSI is correlated with other prognosis factors of endometrial carcinoma, such as non-endometroid histological type, high tumor grade and the depth of myometrial invasion. As a consequence, its value as an independent prognosis factor of endometrial carcinoma is controversial, not having been included over the last few years as a risk group modifying parameter in the main national or international clinical guidelines...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Obstetricia y Ginecología, leída el 25-04-2017