TY - JOUR
T1 - Improved Risk Prediction in Human Papillomavirus-Associated Endocervical Adenocarcinoma Through Assessment of Binary Silva Pattern-based Classification
T2 - An International Multicenter Retrospective Observational Study Led by the International Society of Gynecological Pathologists (ISGyP)
AU - Powell, Aime
AU - Hodgson, Anjelica
AU - Cohen, Paul A.
AU - Rabban, T. Joseph
AU - Park, Kay J.
AU - McCluggage, W. Glenn
AU - Gilks, C. Blake
AU - Singh, Naveena
AU - Oliva, Esther
AU - Cardinal, Lucia H.
AU - Díaz, Lili B.
AU - Falcón, Florencia
AU - Garcia Kamermann, Florencia A.
AU - Sciaccaluga, Maria D.
AU - Bittinger, Sophie
AU - Bulsara, Max
AU - Codde, Jim
AU - Newman, Marsali R.
AU - Spinderjeet, Samra
AU - Talia, Karen L.
AU - Volchek, Mila
AU - Djordevic, Bojana
AU - Hoang, Lien
AU - Parra-Herran, Carlos
AU - Turashvili, Gulisa
AU - Gao, Hong Wen
AU - Jiang, Qingping
AU - Li, Jinhang
AU - Liu, Aijun
AU - Sun, Ping Li
AU - Wang, Yun
AU - Zhang, Jing
AU - Bazalová, Barbora
AU - Bouda, Jirí
AU - Dundr, Pavel
AU - Ondic, Ondrej
AU - Gotthardt, Noel
AU - Hoehn, Anne Kathrin
AU - Horn, Lars Christian
AU - Akakpo, Kafui Patrick
AU - Ayabilah, Edwina Ayaaba
AU - Yarney, Joel
AU - Tse, Ka Yu
AU - Wong, Richard Wing Cheuk
AU - Wong, Tak Siu
AU - Ip, Philip P.C.
AU - Rai, Bhavana
AU - Srinivasan, Radhika
AU - Felix, Ana
AU - Ferreira, Joana
N1 - Funding Information:
Pavel Dundr reports funding from the Ministry of Health, Czech Republic. Andrea Palicelli and Magda Zanelli report partial funding support from the Italian Ministry of Health-Ricerca Corrente Annual Program 2023.
Publisher Copyright:
Copyright © 2024 by the International Society of Gynecological Pathologists.
PY - 2024/9/1
Y1 - 2024/9/1
N2 - Endocervical adenocarcinomas (EACs) are a group of malignant neoplasms associated with diverse pathogenesis, morphology, and clinical behavior. As a component of the International Society of Gynecological Pathologists International Endocervical Adenocarcinoma Project, a large international retrospective cohort of EACs was generated in an effort to study potential clinicopathological features with prognostic significance that may guide treatment in these patients. In this study, we endeavored to develop a robust human papillomavirus (HPV)-associated EAC prognostic model for surgically treated International Federation of Gynecology and Obstetrics (FIGO) stage IA2 to IB3 adenocarcinomas incorporating patient age, lymphovascular space invasion (LVSI) status, FIGO stage, and pattern of invasion according to the Silva system (traditionally a 3-tier system). Recently, a 2-tier/binary Silva pattern of invasion system has been proposed whereby adenocarcinomas are classified into low-risk (pattern A/pattern B without LVSI) and high-risk (pattern B with LVSI/pattern C) categories. Our cohort comprised 792 patients with HPV-associated EAC. Multivariate analysis showed that a binary Silva pattern of invasion classification was associated with recurrence-free and disease-specific survival (P < 0.05) whereas FIGO 2018 stage I substages were not. Evaluation of the current 3-tiered system showed that disease-specific survival for those patients with pattern B tumors did not significantly differ from that for those patients with pattern C tumors, in contrast to that for those patients with pattern A tumors. These findings underscore the need for prospective studies to further investigate the prognostic significance of stage I HPV-associated EAC substaging and the inclusion of the binary Silva pattern of invasion classification (which includes LVSI status) as a component of treatment recommendations.
AB - Endocervical adenocarcinomas (EACs) are a group of malignant neoplasms associated with diverse pathogenesis, morphology, and clinical behavior. As a component of the International Society of Gynecological Pathologists International Endocervical Adenocarcinoma Project, a large international retrospective cohort of EACs was generated in an effort to study potential clinicopathological features with prognostic significance that may guide treatment in these patients. In this study, we endeavored to develop a robust human papillomavirus (HPV)-associated EAC prognostic model for surgically treated International Federation of Gynecology and Obstetrics (FIGO) stage IA2 to IB3 adenocarcinomas incorporating patient age, lymphovascular space invasion (LVSI) status, FIGO stage, and pattern of invasion according to the Silva system (traditionally a 3-tier system). Recently, a 2-tier/binary Silva pattern of invasion system has been proposed whereby adenocarcinomas are classified into low-risk (pattern A/pattern B without LVSI) and high-risk (pattern B with LVSI/pattern C) categories. Our cohort comprised 792 patients with HPV-associated EAC. Multivariate analysis showed that a binary Silva pattern of invasion classification was associated with recurrence-free and disease-specific survival (P < 0.05) whereas FIGO 2018 stage I substages were not. Evaluation of the current 3-tiered system showed that disease-specific survival for those patients with pattern B tumors did not significantly differ from that for those patients with pattern C tumors, in contrast to that for those patients with pattern A tumors. These findings underscore the need for prospective studies to further investigate the prognostic significance of stage I HPV-associated EAC substaging and the inclusion of the binary Silva pattern of invasion classification (which includes LVSI status) as a component of treatment recommendations.
KW - Endocervical adenocarcinoma
KW - HPV
KW - Pattern-based classification system
KW - Prognosis
KW - Silva pattern
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=85201852003&partnerID=8YFLogxK
U2 - 10.1097/PGP.0000000000001033
DO - 10.1097/PGP.0000000000001033
M3 - Article
C2 - 39164939
AN - SCOPUS:85201852003
SN - 0277-1691
VL - 43
SP - 436
EP - 446
JO - International Journal of Gynecological Pathology
JF - International Journal of Gynecological Pathology
IS - 5
ER -
