Prognostic relevance of low-grade versus high-grade FIGO IB1 squamous cell uterine cervical carcinomas
| Autor: | Karl Bilek, Uta Fischer, Lars-Christian Horn, AK Höhn, Bettina Hentschel, Christine E Brambs |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male 0301 basic medicine Cancer Research medicine.medical_specialty Multivariate analysis Cell Uterine Cervical Neoplasms Lymph node metastasis Adenocarcinoma Gastroenterology Cohort Studies Young Adult 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Neoplasm Invasiveness Lymph node Cervix Aged Neoplasm Staging Hematology business.industry Hazard ratio General Medicine Middle Aged Survival Rate 030104 developmental biology medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Carcinoma Squamous Cell Female Histopathology Neoplasm Grading Neoplasm Recurrence Local business Follow-Up Studies |
| Zdroj: | Journal of Cancer Research and Clinical Oncology. 145:457-462 |
| ISSN: | 1432-1335 0171-5216 |
| DOI: | 10.1007/s00432-018-2793-3 |
| Popis: | Tumor grade is one of the more controversial factors with limited prognostic information in squamous cell carcinomas (SCC) of the uterine cervix. Histologic slides of 233 surgically treated cervical SCC (FIGO IB1) were re-examined regarding the prognostic impact of the WHO-based grading system, using the different degree of keratinization, categorizing the tumors in G1, G2 and G3 (conventional tumor grade). 45.1% presented with well-differentiated tumors (G1), 29.2% with moderate (G2) and 25.8% with poor differentiation (G3). Tumor grade significantly correlated with decreased recurrence-free and overall survival. However, detailed analyses between G1- and G2-tumors failed to show any correlation with either recurrence-free or overall survival. G1- and G2-tumors were therefore merged into low-grade tumors and were compared to the high-grade group (G3-tumors). This binary conventional grading system showed an improved 5-years recurrence-free (low-grade: 90.2% vs. high-grade: 71.6%; p = 0.001) and overall survival rates (low-grade: 89.9% vs. high-grade: 71.1%; p = 0.001) for low-grade tumors. On multivariate analysis adjusted for lymph node metastasis, high-grade tumors represented a hazard ratio of 2.4 (95% CI 1.3–4.7) for reduced recurrence-free and 2.4 (95% CI 1.2–4.6) for overall survival. High-grade tumors showed a significantly higher risk for pelvic lymph node involvement [OR 2.7 (95% CI 1.4–5.5); p = 0.003]. The traditional three-tiered grading system failed to predict pelvic lymph node metastases. A binary grading model for the conventional tumor grade (based on the degree of keratinization) in SCC of the uterine cervix may allow a better prognostic discrimination than the traditionally used three-tiered system. |
| Databáze: | OpenAIRE |
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