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Prognostic relevance of low-grade versus high-grade FIGO IB1 squamous cell uterine cervical carcinomas.

Abstract：

PURPOSE:Tumor grade is one of the more controversial factors with limited prognostic information in squamous cell carcinomas (SCC) of the uterine cervix. METHODS: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). RESULTS: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. CONCLUSION: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.

journal_name

J Cancer Res Clin Oncol

journal_title

Journal of cancer research and clinical oncology

authors

Horn LC,Höhn AK,Hentschel B,Fischer U,Bilek K,Brambs CE

doi

10.1007/s00432-018-2793-3

subject

Has Abstract

pub_date

2019-02-01 00:00:00

pages

457-462

issue

eissn

0171-5216

issn

1432-1335

pii

10.1007/s00432-018-2793-3

journal_volume

145

pub_type

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Prognostic relevance of low-grade versus high-grade FIGO IB1 squamous cell uterine cervical carcinomas.