{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T06:01:27Z","timestamp":1784700087491,"version":"3.55.0"},"reference-count":19,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T00:00:00Z","timestamp":1783814400000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To evaluate the prognostic significance of lymphovascular space invasion (LVSI), classified according to the 2020 World Health Organization (WHO) criteria, on disease\u2010free survival (DFS) and overall survival (OS) in endometrial cancer, and to characterize the prognosis of LVSI\u2010positive, lymph node\u2010negative disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective single\u2010center cohort study included 568 patients with endometrial carcinoma who underwent primary surgical treatment with comprehensive surgical staging, including lymph node assessment, between January 2023 and December 2025. LVSI was classified as absent, focal, or substantial. Survival outcomes were estimated by the Kaplan\u2013Meier method and compared by log\u2010rank test. Independent predictors of DFS and OS were identified by multivariable Cox proportional hazards regression. A four\u2010group analysis combining LVSI and lymph node status was also performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      LVSI was absent in 413 patients (72.7%), focal in 39 (6.9%), and substantial in 116 (20.4%). Median follow\u2010up was 20.0\u2009months. On multivariable analysis, substantial LVSI was an independent predictor of reduced DFS (HR 2.22, 95% CI: 1.14\u20134.32;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.018) and OS (HR 3.48, 95% CI: 1.34\u20139.00;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.010), whereas focal LVSI did not retain independent prognostic significance. LVSI\u2010positive\/lymph node\u2010negative patients had significantly worse DFS than LVSI\u2010negative\/lymph node\u2010negative patients (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and did not differ significantly from LVSI\u2010negative\/lymph node\u2010positive patients (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.065), suggesting recurrence outcomes approaching those of node\u2010positive disease.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Substantial LVSI is an independent adverse prognostic factor in endometrial cancer. LVSI\u2010positive\/lymph node\u2010negative patients demonstrated recurrence outcomes approaching those of lymph node\u2010positive disease; given the limited follow\u2010up, this finding is hypothesis\u2010generating and requires prospective validation before informing treatment escalation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jog.70408","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:50:40Z","timestamp":1783903840000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic Impact of\n                    <scp>WHO<\/scp>\n                    2020 Lymphovascular Space Invasion Categories in Endometrial Cancer: Substantial\n                    <scp>LVSI<\/scp>\n                    as an Independent Risk Factor and the Behavior of\n                    <scp>LVSI<\/scp>\n                    \u2010Positive, Node\u2010Negative Disease"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2102-3183","authenticated-orcid":false,"given":"G\u00f6k\u00e7en","family":"Ege","sequence":"first","affiliation":[{"name":"Department of Gynecologic Oncology Ankara Etlik City Hospital  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9407-2704","authenticated-orcid":false,"given":"Hande Nur","family":"\u00d6nc\u00fc","sequence":"additional","affiliation":[{"name":"Department of Gynecologic Oncology Ankara Etlik City Hospital  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4056-9037","authenticated-orcid":false,"given":"Hasan Volkan","family":"Ege","sequence":"additional","affiliation":[{"name":"Department of Gynecologic Oncology Ankara Etlik City Hospital  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5578-8718","authenticated-orcid":false,"given":"Neslihan","family":"\u00d6zt\u00fcrk","sequence":"additional","affiliation":[{"name":"Department of Gynecologic Oncology Ankara Etlik City Hospital  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0511-925X","authenticated-orcid":false,"given":"\u015eahin Kaan","family":"Baydemir","sequence":"additional","affiliation":[{"name":"Department of Gynecologic Oncology Ankara Etlik City Hospital  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9159-7476","authenticated-orcid":false,"given":"O\u011fuz Kaan","family":"K\u00f6ksal","sequence":"additional","affiliation":[{"name":"Department of Gynecologic Oncology Ankara Etlik City Hospital  Ankara 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