Dataset for the Reporting of Carcinoma of the Cervix: Recommendations From the International Collaboration on Cancer Reporting (ICCR)

Park, Kay J.; Selinger, Christina; Alvarado‐Cabrero, Isabel; Duggan, Máire A.; Kiyokawa, Takako; Mills, Anne M.; Ordï, Jaume; Otis, Christopher N.; Plante, Marie; Stolnicu, Simona; Talia, Karen L.; Wiredu, Edwin K.; Lax, Sigurd; McCluggage, W. Glenn

doi:10.1097/pgp.0000000000000909

Cited by 17 publications

(15 citation statements)

References 164 publications

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“…Because it was not based on HPV association, the pattern-based 2014 WHO classification of cervical SCCs was replaced in the 2020 WHO classification 1,4 ; the prognostic significance of various morphologic patterns (eg, keratinizing, nonkeratinizing, basaloid, warty/condylomatous, papillary, squamotransitional, and lymphoepithelial-like) was debated and determined to be not reproducible because of nonspecific definitions 4 . While the 2020 WHO classification does not recommend reporting histologic subtypes or growth patterns, we, along with the 2022 International Collaboration on Cancer Reporting (ICCR) guidelines, suggest this information remain in the surgical pathology report in a note or comment, given that primary tumor morphology is significant when looking for similarities to a recurrence 1,25,26 . This information could also be used in research to better understand the interplay between HPV infection, growth patterns, and clinical outcomes (Table 1).…”

Section: Human Papillomavirus-associated Squamous Cell Carcinomasmentioning

confidence: 98%

“…Finding that tumor type assignment (Supplemental Material, Supplemental Digital Content 1, http://links.lww.com/PAP/A34) is neither reproducible nor predictive of survival is consistent with previous studies that concluded this value has limited implications in SCCs. Consequently, removing these variables from the 2020 WHO classification and no longer recognizing them as core data in pathology reports are justified 1,26 …”

Section: Reproducibility Of Different Growth Patterns (Original Vs Co...mentioning

confidence: 99%

“…4 While the 2020 WHO classification does not recommend reporting histologic subtypes or growth patterns, we, along with the 2022 International Collaboration on Cancer Reporting (ICCR) guidelines, suggest this information remain in the surgical pathology report in a note or comment, given that primary tumor morphology is significant when looking for similarities to a recurrence. 1,25,26 This information could also be used in research to better understand the interplay between HPV infection, growth patterns, and clinical outcomes (Table 1).…”

Section: Human Papillomavirus-associated Squamous Cell Carcinomasmentioning

confidence: 99%

“…Lymphovascular space invasion (LVSI), identified at the periphery of the tumor, is frequently present and is now increasingly quantitated by distinguishing between focal versus extensive (more than 3 or 5 intravascular tumor emboli) LVSI. [26][27][28]…”

Section: Typical Histologic Appearances Of Human Papillomavirus-assoc...mentioning

confidence: 99%

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Invasive Squamous Cell Carcinoma of the Cervix: A Review of Morphological Appearances Encountered in Human Papillomavirus-associated and Papillomavirus-independent Tumors and Precursor Lesions

Stolnicu,

Allison,

Patrichi

et al. 2023

Advances in Anatomic Pathology

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Cervical cancer is the fourth most common cancer among women globally. Historically, human papillomavirus (HPV) infection was considered necessary for the development of both precursor and invasive epithelial tumors of the cervix; however, studies in the last decade have shown that a significant proportion of cervical carcinomas are HPV-independent (HPVI). The 2020 World Health Organization (WHO) Classification of Female Genital Tumors separates both squamous cell carcinomas (SCCs) and endocervical adenocarcinomas (ECAs) by HPV status into HPV-associated (HPVA) and HPVI tumors. The classification further indicates that, in contrast to endocervical adenocarcinomas, HPVI and HPVA SCCs cannot be distinguished by morphological criteria alone and suggests that HPV testing or correlates thereof are required for correct classification. Moreover, while HPVA SCC precursor lesions (ie, high-grade squamous intraepithelial lesion) are well known and characterized, precursors to HPVI SCCs have only been described recently in a small number of cases. We studied 670 cases of SCCs from the International Squamous Cell Carcinoma Project (ISCCP) to analyze the reproducibility of recognition of invasive SCC growth patterns, presence of lymphovascular space invasion, tumor grade, and associations with patient outcomes. Consistent with previous studies, we found histologic growth patterns and tumor types had limited prognostic implications. In addition, we describe the wide morphologic spectrum of HPVA and HPVI SCCs and their precursor lesions, including tumor growth patterns, particular and peculiar morphologic features that can lead to differential diagnoses, and the role of ancillary studies in the diagnosis of these tumors.

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Section: Human Papillomavirus-associated Squamous Cell Carcinomasmentioning

confidence: 98%

Section: Reproducibility Of Different Growth Patterns (Original Vs Co...mentioning

confidence: 99%

Section: Human Papillomavirus-associated Squamous Cell Carcinomasmentioning

confidence: 99%

Section: Typical Histologic Appearances Of Human Papillomavirus-assoc...mentioning

confidence: 99%

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Invasive Squamous Cell Carcinoma of the Cervix: A Review of Morphological Appearances Encountered in Human Papillomavirus-associated and Papillomavirus-independent Tumors and Precursor Lesions

Stolnicu,

Allison,

Patrichi

et al. 2023

Advances in Anatomic Pathology

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“…After its first description in 2013, 1 the pattern‐based classification of HPV‐associated endocervical adenocarcinoma (HPVA) has been the subject of numerous studies, which have validated its role in predicting lymph node involvement, tumour recurrence and patient outcome 2–5 . The current National Comprehensive Cancer Network (NCCN) guidelines for the management of cervical cancer now include the pattern‐based classification for HPV‐associated endocervical adenocarcinoma (HPVA) as an emerging concept, 6 and the latest guidelines by the International Society of Gynaecological Pathologists 7 and the International Collaboration on Cancer Reporting 8 recommend including the invasive pattern in the diagnostic report.…”

Section: Introductionmentioning

confidence: 99%

Pattern A endocervical adenocarcinomas with ovarian metastasis are indolent and molecularly distinct from destructively invasive adenocarcinomas

Neil,

Li,

Hakam

et al. 2023

Histopathology

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AimsThe invasive pattern in HPV‐associated endocervical adenocarcinoma (HPVA) has prognostic value. Non‐destructive (pattern A) HPVA has excellent prognosis mirroring adenocarcinoma in‐situ (AIS). However, the rare occurrence of ovarian spread in these tumours suggests aggressiveness in a subset of patients with these otherwise indolent lesions. We hypothesise that AIS/pattern A HPVA with ovarian metastases are biologically different than metastatic destructively invasive HPVA.Methods and resultsSamples from patients with HPVA and synchronous or metachronous metastases were retrieved and reviewed to confirm diagnosis and determine the Silva pattern in the primary lesion. For each case, normal tissue, cervical tumour and at least one metastasis underwent comprehensive sequencing using a 447‐gene panel. Pathogenic single‐nucleotide variants and segmental copy‐number alterations (CNA), tumour mutational burden and molecular signatures were evaluated and compared between primary and metastases and among invasive pattern categories. We identified 13 patients: four had AIS/pattern A primaries, while nine had pattern B/C tumours. All AIS/pattern A lesions had metastasis only to ovary; 50% of patients with ovarian involvement, regardless of invasive pattern, also had involvement of the endometrium and/or fallopian tube mucosa by HPVA. In the ovary, AIS/pattern A HPVA showed deceptive well‐differentiated glands, often with adenofibroma‐like appearance. Conversely, pattern C HPVAs consistently showed overt infiltrative features in the ovary. Sequencing confirmed the genetic relationship between primary and metastatic tumours in each case. PIK3CA alterations were identified in three of four AIS/pattern A HPVAs and three of eight pattern B/C tumours with sequenced metastases. Pattern C tumours showed a notably higher number of CNA in primary tumours compared to pattern A/B tumours. Only one metastatic AIS/pattern A HPVA had a novel pathogenic variant compared to the primary. Conversely, five of eight pattern B/C tumours with sequenced metastases developed novel pathogenic variants in the metastasis not seen in the primary. All four AIS/pattern A patients were alive and free of disease at 31, 47, 58 and 212 months after initial diagnosis. Conversely, cancer‐related death was documented in five of nine pattern B/C patients with follow‐up at 7, 20, 20, 43 and 87 months.ConclusionMorphologically and genomically, AIS/pattern A HPVA with secondary ovarian involvement appears distinct from destructively invasive tumours. In at least a subset of these cases, ovarian spread appears to occur via trans‐Mullerian superficial extension, different from the stromal and lymphatic vascular spread typical of more aggressive tumours (pattern C). These differences may explain the indolent outcome observed in the rare subset of patients with AIS/pattern A HPVA and ovarian metastasis. Our data underscore the potential for conservative surgical management approaches to pattern A HPVA.

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TNM/FIGO Classification, Pathology of the Cervix

Hoang

2023

Encyclopedia of Pathology

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Dataset for the Reporting of Carcinoma of the Cervix: Recommendations From the International Collaboration on Cancer Reporting (ICCR)

Cited by 17 publications

References 164 publications

Invasive Squamous Cell Carcinoma of the Cervix: A Review of Morphological Appearances Encountered in Human Papillomavirus-associated and Papillomavirus-independent Tumors and Precursor Lesions

Invasive Squamous Cell Carcinoma of the Cervix: A Review of Morphological Appearances Encountered in Human Papillomavirus-associated and Papillomavirus-independent Tumors and Precursor Lesions

Pattern A endocervical adenocarcinomas with ovarian metastasis are indolent and molecularly distinct from destructively invasive adenocarcinomas

TNM/FIGO Classification, Pathology of the Cervix

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