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

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 end...

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Bibliographic Details
Published in:Gynecologic oncology 2018-07, Vol.150 (1), p.56-60
Main Authors: 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.
Format: Article
Language:English
Subjects:
Adenocarcinoma - mortality
Adenocarcinoma - pathology
Cervical cancer
Female
Human papillomavirus
Humans
Lymphatic Metastasis - immunology
Lymphovascular invasion
Metastasis
Neoplasm Recurrence, Local
Papillomaviridae - pathogenicity
Papillomavirus Infections - pathology
Pathology
Recurrence
Risk Factors
Survival Rate
Uterine Cervical Neoplasms - mortality
Uterine Cervical Neoplasms - pathology
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Summary: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. 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. 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 
ISSN:0090-8258
1095-6859
DOI:10.1016/j.ygyno.2018.04.570