Tumor Necrotic Debris and High Nuclear Grade: Newly Identified High-risk Factors for Early-stage Endocervical Adenocarcinoma
| Autor: | Wenxin Zheng, Steven Holloway, Glorimar Rivera Colon, Jayanthi S. Lea |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Oncology
Adult congenital hereditary and neonatal diseases and abnormalities Cancer Research medicine.medical_specialty Uterine Cervical Neoplasms Pilot Projects Disease Adenocarcinoma 03 medical and health sciences Necrosis 0302 clinical medicine Risk Factors Internal medicine medicine Humans 030212 general & internal medicine Stage (cooking) Nuclear grade Aged Neoplasm Staging Cervical cancer Cell Nucleus business.industry Reproducibility of Results Middle Aged medicine.disease Lymphovascular Endocervical Adenocarcinoma 030220 oncology & carcinogenesis Risk stratification Female Necrotic debris Neoplasm Grading Neoplasm Recurrence Local business Follow-Up Studies |
| Zdroj: | American journal of clinical oncology. 44(4) |
| ISSN: | 1537-453X |
| Popis: | Objective Invasive pattern of endocervical adenocarcinomas (EACs) is known to influence lymph node metastasis and cancer recurrence. In this study we describe the prognostic significance of necrotic tumor debris (NTD) and tumor nuclear grade on recurrence risk stratification of early-stage cervical adenocarcinoma. Methods Patients who underwent surgery from 2007 to 2018 for International Federation of Gynecology and Obstetrics (FIGO) stage IA1-IB2 EAC, for whom pathology was available for review were included in this study. Clinico-pathologic variables and clinical recurrence risk stratification (low, intermediate, or high risk) were correlated to intraluminal NTD and tumor nuclear grade (N3). Results Among 50 patients meeting inclusion criteria, all were managed surgically and clinically risk stratified as low (n=33), intermediate (n=13), and high risk (n=4). Twenty-three patients (46%) were NTD-N3 negative and 27 (54%) were NTD-N3 positive. NTD-N3 was significantly associated with higher stage, tumor grade, larger tumor size, positive lymphovascular space invasion, and recurrence of disease (P=0.025). Patients with stage IB1 EAC who were stratified as intermediate or high-risk for recurrence were positive for NTD-N3. Lack of NTD-N3 had 100% negative predictive value for disease recurrence. Conclusions NTD-N3, a novel pathologic finding, may be used to further stratify overall recurrence risk, and may play a role in individualization of patient care in early-stage EAC. |
| Databáze: | OpenAIRE |
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