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Stromal invasion pattern identifies patients at lowest risk of lymph node metastasis in HPV-associated endocervical adenocarcinomas, but is irrelevant in adenocarcinomas unassociated with HPV
| Content Provider | Scilit |
|---|---|
| Author | Stolnicu, S. Barsan, I. Hoang, L. Patel, P. Terinte, C. Pesci, A. Aviel-Ronen, S. Kiyokawa, T. Alvarado-Cabrero, I. Oliva, E. Park, K. J. Abu-Rustum, N. R. Pike, M. C. Soslow, R. A. |
| Copyright Year | 2018 |
| Description | Journal: Gynecologic Oncology Objective The Silva invasion pattern-based classification system stratifies endocervical adenocarcinomas (ECAs) into 3 categories corresponding to risk of metastasis and recurrence, but has only been evaluated for HPV-associated ECAs of usual type. We examined whether the Silva system is applicable to all endocervical adenocarcinomas, especially those not associated with HPV. Methods Complete slide sets from 341 surgical specimens of ECA were collected from 7 institutions worldwide. All specimens were associated with clinical records covering at least 5 years of follow-up. Tumors were classified as HPV-associated (HPVA) or not (NHPVA) by both morphology and detection of HPV using in situ hybridization. Recurrence and survival were analyzed by multivariate Mantel-Haenszel methods. Results Most specimens (292; 85.6%) were HPVA, while 49 (14.3%) were NHPVA. All NHPVAs were Silva pattern C, while 76.0% of HPVAs were pattern C, 14.7% pattern A, and 9.3% pattern B. Including both HPVAs and NHPVAs, lymphovascular invasion (LVI) was detected in 0% of pattern A, 18.5% of pattern B and 62.6% of pattern C cases (p < 0.001). None of the pattern A or B cases were associated with lymph node metastases (LNM), in contrast to pattern C cases (21.8%). Among patients with Silva pattern C ECA, those with HPVA tumors had a lower recurrence rate and better survival than those with NHPVA; however, when adjusted for stage at diagnosis, the difference in recurrence and mortality was small and not statistically significant. Conclusions Application of the Silva system is only relevant in HPVA cervical adenocarcinoma. |
| Related Links | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6615482/pdf http://www.gynecologiconcology-online.net/article/S0090825818308485/pdf |
| Ending Page | 60 |
| Page Count | 5 |
| Starting Page | 56 |
| ISSN | 00908258 |
| e-ISSN | 10956859 |
| DOI | 10.1016/j.ygyno.2018.04.570 |
| Journal | Gynecologic Oncology |
| Issue Number | 1 |
| Volume Number | 150 |
| Language | English |
| Publisher | Elsevier BV |
| Publisher Date | 2018-05-30 |
| Access Restriction | Open |
| Subject Keyword | Journal: Gynecologic Oncology Human Papillomavirus Lymphovascular Invasion |
| Content Type | Text |
| Resource Type | Article |
| Subject | Oncology Obstetrics and Gynecology |
