Pattern of invasion is of prognostic value in surgically treated cervical cancer patients

  • Objectives: Different patterns of invasion (representing different grades of tumor cell dissociation) are associated with prognostic outcome in cancer. We evaluated the prognostic value of different patterns of invasion (PI) in cervical carcinomas (CX). Methods: Six hundred eleven surgically treated CX (FIGO IB to IIB) were re-evaluated histologically regarding the PI, using a three-level scoring system. Closed PI was defined as cohesive growth with well-delineated (pushing) borders. In finger-like PI the tumor grows in solid cords/trabecles. Highly dissociative growth in small groups or single cells was defined as spray-like PI. Types of PI were correlated to tumor stage, histo-morphologic factors and prognostic outcome. Results: Sixty percent of the tumors showed a spray-like PI, 30% a finger-like PI and only 7.4% were of the closed type. Spray-like PI showed a significant correlation with advanced stage disease, lymphovascular space involvement, poorly differentiated tumors and pelvic lymph node metastases. Spray-like PI was accompanied by a reduced 5-year overall survival when compared to the finger-like and closed PI (68.7% vs. 80.9% vs. 88.5%; P=0.0004). The prognostic impact of the PI disappeared in node-positive patients (P=0.06) but persisted in patients without pelvic lymph node disease (P=0.03). In multivariate analysis, using COX regression model, the PI represented as independent prognostic factor. Conclusions: Spray-like PI (i.e., highest degree of tumor cell dissociation) is associated with advanced tumor stages, increased rate of recurrency and a reduced overall survival. In separate analysis of patients with and without lymph node metastases, the impact of PI persisted only in node-negative cases as a prognostic factor.

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Metadaten
Author:Lars-Christian Horn, Uta Fischer, Georgios RaptisORCiDGND, Karin Bilek, Bettina Hentschel, Christine E. Richter, Ulf Dietrich Braumann, Jens Einenkel
DOI:https://doi.org/10.1016/j.ygyno.2006.05.046
Parent Title (English):Gynecologic Oncology
Document Type:Article
Language:English
Year of first Publication:2006
Release Date:2020/06/05
GND Keyword:Gebärmutterhalskrebs; Chirurgie; Metastase
Volume:103
Issue:3
First Page:906
Last Page:911
Institutes:Fakultät Informatik und Mathematik
Fakultät Informatik und Mathematik / Labor eHealth (eH)
Publication:Externe Publikationen
research focus:Lebenswissenschaften und Ethik