LAUSR

Objectives The detection of circulating (CTCs) and invasive circulating tumor cells (iCTCs) in the peripheral blood of women with epithelial ovarian cancer (EOC) has been proven to be feasible and prognostic. The deleterious impact of lymphovascular space invasion (LVSI) has been well-established in various gynecologic malignancies (e.g., vulvar, cervical, endometrial) but has not been extensively evaluated in EOC. The goal of this study is to evaluate the correlation between CTCs, iCTCs and LVSI in patients with EOC. Methods Peripheral blood samples from 85 patients with EOC were assessed for the presence of CTCs and iCTCs using our functional cell adhesion matrix (CAM) enrichment method. The histopathology slides from each patient were reviewed by two gynecologic oncology pathologists for histologic type, grade, presence or absence of LVSI, extent of the LVSI (focal or multifocal) and location (organ site). Results High levels of CTCs and iCTCs were significantly associated with advanced stage but not with grade, debulking status, platinum sensitivity, lymphovascular space invasion, age, or overall survival. High levels of CTCs and iCTCs were positively correlated. Lymphovascular space invasion was significantly associated with decreased overall survival (median: 1194 vs. 2034 days, p=0.02) but not with stage, grade, debulking status, platinum sensitivity, median or high levels of CTCs or iCTS, or age. Conclusions Lymphovascular space invasion is an independent risk factor for women with EOC, but was not associated with levels of circulating tumor cells. These findings suggest that these two circulations have distinct mechanisms by which they contribute to spread of ovarian cancer.