Pelvic lymph node involvement and risk of recurrence in HPV-associated endocervical adenocarcinoma stage IA2-IB1 according to Silva's system in two Colombian cancer centers.

Autor: Hernández JA; Department of Gynecologic Oncology, Instituto Nacional de Cancerología, Bogotá, Colombia., Rodríguez J; Section of Gynecologic Oncology, Department of Gynecology and Obstetrics, Fundación Santa Fe de Bogotá, Bogotá, Colombia.; Cancer Clinical and Epidemiological Research Group, Instituto Nacional de Cancerología, Bogotá, Colombia.; Department of Obstetrics and Gynecology, Universidad Nacional de Colombia, Bogotá, Colombia., Rendón G; Department of Gynecologic Oncology, Instituto de Cancerología Las Américas - AUNA, Medellín, Colombia., Trujillo LM; Department of Gynecologic Oncology, Instituto Nacional de Cancerología, Bogotá, Colombia., Beltrán MI; Department of Pathology Oncology, Instituto Nacional de Cancerología, Bogotá, Colombia., Mantilla C; Department of Pathology Oncology, Instituto Nacional de Cancerología, Bogotá, Colombia., Echeverry C; Department of Pathology Oncology, Clínica Las Américas - AUNA, Medellín, Colombia., Mendoza MA; Department of Pathology Oncology, Clínica Las Américas - AUNA, Medellín, Colombia., Gil M; Department of Pathology Oncology, Clínica Las Américas - AUNA, Medellín, Colombia., Núñez M; Research Support and Follow-up Group, Instituto Nacional de Cancerología, Bogotá, Colombia., Hernández M; Health Information Systems Group, Instituto de Cancerología Clínica Las Américas, Medellín, Colombia., Peralta J; Department of Gynecologic Oncology, Instituto Nacional de Cancerología, Bogotá, Colombia., Pareja R; Department of Gynecologic Oncology, Instituto Nacional de Cancerología, Bogotá, Colombia.; Clínica Astorga, Medellín, Colombia.
Jazyk: angličtina
Zdroj: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics [Int J Gynaecol Obstet] 2024 Sep; Vol. 166 (3), pp. 1232-1239. Date of Electronic Publication: 2024 Mar 28.
DOI: 10.1002/ijgo.15482
Abstrakt: Objective: To compare the pelvic lymph node involvement and risk of recurrence in patients with human papillomavirus (HPV)-associated endocervical adenocarcinoma stage IA2-IB1 undergoing hysterectomy and/or trachelectomy plus lymphadenectomy, according to Silva's classification system.
Methods: A retrospective cohort study was performed in two Colombian cancer centers. The cases were classified according to the Silva classification system. Clinical, surgical, and histopathological variables were evaluated. Recurrence risk was analyzed by patterns A, B, or C. A logistic regression model was performed for tumor recurrence. The Kaplan-Meier method was used to estimate overall survival and disease-free survival (DFS). A weighted kappa was performed to determine the degree of concordance between pathologists.
Results: A total of 100 patients were identified, 33% pattern A, 29% pattern B, and 38% pattern C. The median follow-up time was 42.5 months. No evidence of lymph node involvement was found in patients classified as A and B, while in the C pattern was observed in 15.8% (n = 6) of cases (P < 0.01). There were 7% of cases with recurrent disease, of which 71.5% corresponded to type C pattern. Patients with Silva pattern B and C had 1.22- and 4.46-fold increased risk of relapse, respectively, compared with pattern A. The 5-year DFS values by group were 100%, 96.1%, and 80.3% for patterns A, B, and C, respectively.
Conclusion: For patients with early-stage HPV-associated endocervical adenocarcinoma, the type C pattern presented more lymph node involvement and risk of recurrence compared to the A and B patterns. The concordance in diagnosis of different Silva's patterns by independents pathologists were good.
(© 2024 International Federation of Gynecology and Obstetrics.)
Databáze: MEDLINE
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