Geburtshilfe Frauenheilkd 2018; 78(10): 101
DOI: 10.1055/s-0038-1671052
Poster
Donnerstag, 01.11.2018
Gynäkologische Onkologie VII
Georg Thieme Verlag KG Stuttgart · New York

Introducing a novel highly prognostic grading scheme based on tumor budding and cell nest size for squamous cell carcinoma of the uterine cervix

M Jesinghaus
1  Pathologisches Institut der Technischen Universität München, München, Deutschland
2  German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Deutschland
,
J Strehl
3  Pathologisches Institut Universitätsklinikum Erlangen, Erlangen, Deutschland
,
M Boxberg
1  Pathologisches Institut der Technischen Universität München, München, Deutschland
,
A Wenzel
1  Pathologisches Institut der Technischen Universität München, München, Deutschland
,
F Brühl
1  Pathologisches Institut der Technischen Universität München, München, Deutschland
,
B Konukiewitz
1  Pathologisches Institut der Technischen Universität München, München, Deutschland
,
AM Schlitter
1  Pathologisches Institut der Technischen Universität München, München, Deutschland
,
K Steiger
1  Pathologisches Institut der Technischen Universität München, München, Deutschland
,
A Warth
4  Pathologisches Institut der Universität Heidelberg, Heidelberg, Deutschland
,
A Schnelzer
5  Frauenklinik der Technischen Universität München, München, Deutschland
,
M Kiechle
5  Frauenklinik der Technischen Universität München, München, Deutschland
,
MW Beckmann
6  Frauenklinik Universitätsklinikum Erlangen, Gynäkologische Onkologie, Erlangen, Deutschland
,
A Noske
1  Pathologisches Institut der Technischen Universität München, München, Deutschland
,
A Hartmann
3  Pathologisches Institut Universitätsklinikum Erlangen, Erlangen, Deutschland
,
G Mehlhorn
3  Pathologisches Institut Universitätsklinikum Erlangen, Erlangen, Deutschland
6  Frauenklinik Universitätsklinikum Erlangen, Gynäkologische Onkologie, Erlangen, Deutschland
,
W Weichert
1  Pathologisches Institut der Technischen Universität München, München, Deutschland
2  German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Deutschland
,
M Koch
6  Frauenklinik Universitätsklinikum Erlangen, Gynäkologische Onkologie, Erlangen, Deutschland
› Author Affiliations
Further Information

Publication History

Publication Date:
20 September 2018 (online)

 

Objective:

Recently, it has been shown for several squamous cell carcinoma tumor entities that a grading approach incorporating the factors budding activity and cell nest size strongly outperforms conventional grading algorithms with respect to its prognostic value. Here, we tested this novel approach in two completely independent cohorts of cervical squamous cell carcinoma.

Material:

In order to improve morphology based grading, we determined budding activity and cell nest size as well as several other morphological factors in a test cohort (n = 125) and a completely independent validation cohort (n = 122) of cervical squamous cell carcinoma. Parameters were correlated with outcome and clinical factors.

Results:

As in several other squamous cell carcinoma entities, small cell nest size and high budding activity in cervical squamous cell carcinoma predicted a dismal patient prognosis (p < 0.001 for overall, disease-specific and disease-free survival) in our test cohort. A grading algorithm incorporating these two parameters was a stage independent prognosticator in the test cohort. Hazard ratio (HR) of this novel grading algorithm for OS was 2.3 for G2 and 5.1 for G3 tumors when compared to G1 neoplasms (p = 0.010). In the validation cohort HR for OS was 3.0 for G2 and 7.2 for G3 tumors (p = 0.012).

Conclusion:

Comparable to esophageal, lung and oral squamous cell carcinoma, in cervical carcinoma a grading algorithm incorporating cell nest size and budding activity had strong independent prognostic impact. We suggest this grading algorithm as an additional morphology based parameter in the routine diagnostic assessment for this tumor entity.