医学
淋巴血管侵犯
阶段(地层学)
比例危险模型
子宫颈
回顾性队列研究
肿瘤科
内科学
妇科
放射科
转移
癌症
古生物学
生物
作者
Aaron Praiss,Douglas Allison,Basile Tessier‐Cloutier,Jessica Flynn,Alexia Iasonos,Lynn Hoang,Andrei Patrichi,Cristina Terinte,Anna Pesci,Claudia Mateoiu,Ricardo R. Lastra,Lucian Pușcașiu,Takako Kiyokawa,Rouba Ali‐Fehmi,Mira Kheil,Esther Oliva,Kyle M. Devins,Nadeem R. Abu‐Rustum,Robert A. Soslow,Simona Stolnicu
标识
DOI:10.1016/j.ygyno.2023.07.011
摘要
Objective We evaluated clinicopathologic parameters of patients with cervical squamous cell carcinoma (SCC) who were treated with initial surgical management and assessed their relation to survival outcomes. Specifically, we evaluated the relation between extent of lymphovascular invasion (LVI) and survival outcomes. Methods All available tumor slides from patients with initially surgically treated cervical SCC were collected from 10 institutions and retrospectively analyzed. Standard clinicopathological parameters, tumor stroma, and extent of LVI were assessed (focal: <5 spaces, extensive: ≥5 spaces). PFS and OS were evaluated using Kaplan–Meier methodology. Univariable and multivariable Cox proportional hazards models were created to determine prognostic survival-related risk factors. Results A total of 670 tumor samples were included in the analysis. Median age at diagnosis was 47 years (IQR: 38–60), 457 patients (72%) had a 2018 International Federation of Gynecology and Obstetrics (FIGO) stage I tumor, and 155 tumors (28%) were flat and/or ulcerated. There were 303 nonkeratinizing tumors (51%), 237 keratinizing tumors (40%), and 356 histologic grade 2 tumors (61%). Quantifiable LVI was present in 321 cases (51%; 23% focal and 33% extensive). On multivariable analysis for PFS, extensive and focal LVI had worse outcomes compared to negative LVI (HR: 2.38 [95% CI: 1.26–4.47] and HR: 1.54 [95% CI: 0.76–3.11], respectively; P = 0.02). The difference did not reach statistical significance for OS. Conclusion Presence of LVI is a prognostic marker for patients with cervical SCC. Quantification (extensive vs. focal vs. negative) of LVI may be an important biomarker for oncologic outcome.
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