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

Jesinghaus, Moritz; Strehl, Johanna; Boxberg, Melanie; Wenzel, Andrea; Brühl, Frido; Konukiewitz, Björn; Schlitter, AM; Steiger, Katja; Warth, Arne; Schnelzer, Andreas; Kiechle, M; Beckmann, MW; Noske, Aurelia; Hartmann, Arndt; Mehlhorn, Grit; Weichert, Wilko; Koch, Michael

doi:10.1055/s-0038-1671052

Cited by 4 publications

(10 citation statements)

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“…Jesinghaus and colleagues studied two cohorts (test and validation cohorts; n =125 and 122, respectively) of primary resection specimens of cervical squamous cell carcinomas from German patients . All the carcinomas were graded (G1–G3) in accordance with the 2014 WHO classification and also divided into keratinizing and non‐keratinizing neoplasms.…”

Section: Recently Proposed Grading System For Cervical Squamous Cell mentioning

confidence: 99%

“…Histological subtype, nuclear size, and stromal content: representative images of a keratinizing cervical squamous cell carcinoma (G), large tumour cell nuclei (H), and high stromal content (I). Reproduced with permission from .…”

Section: Recently Proposed Grading System For Cervical Squamous Cell mentioning

confidence: 99%

“…Jesinghaus and colleagues studied two cohorts (test and validation cohorts; n 5125 and 122, respectively) of primary resection specimens of cervical squamous cell carcinomas from German patients [3].…”

Section: Introductionmentioning

confidence: 99%

“…It is hoped that the results of this study will be validated in additional independent larger cohorts and will act as an impetus for the development of a meaningful and easy-to-implement grading system for cervical squamous cell carcinoma. As comparable tumour budding/cell nest size-based grading systems have been shown to be of prognostic value for squamous cell carcinomas at other sites, this shows the potential of these parameters to serve as the basis for a common grading system applicable to squamous cell carcinomas of different anatomic sites.No conflicts of interest were declared.Jesinghaus and colleagues studied two cohorts (test and validation cohorts; n 5125 and 122, respectively) of primary resection specimens of cervical squamous cell carcinomas from German patients [3].…”

mentioning

confidence: 99%

“…Proposed new grading system for squamous cell carcinoma of the cervix (Reproduced with permission from[3])…”

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confidence: 99%

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Towards developing a meaningful grading system for cervical squamous cell carcinoma

McCluggage

2018

The Journal of Pathology CR

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Cervical cancer is one of the commonest cancers worldwide, especially in developing countries. In early stage disease, a variety of pathological parameters are of prognostic value but currently this does not include tumour grade which, for a number of reasons, is of limited or no value in cervical squamous cell carcinomas. In a recent article in this journal, Jesinghaus and colleagues investigated a novel histopathological grading system based on tumour budding and cell nest size, which has been shown to outperform conventional grading systems for squamous cell carcinoma at several other sites such as lung, oral cavity, and oesophagus in terms of patient prognostication. They tested the prognostic value of this grading system in two independent cohorts of cervical squamous cell carcinoma. The grading system proved to be a highly effective, stage‐independent prognosticator in both cohorts with small cell nest size and high tumour budding indicative of a poor prognosis. It is hoped that the results of this study will be validated in additional independent larger cohorts and will act as an impetus for the development of a meaningful and easy‐to‐implement grading system for cervical squamous cell carcinoma. As comparable tumour budding/cell nest size‐based grading systems have been shown to be of prognostic value for squamous cell carcinomas at other sites, this shows the potential of these parameters to serve as the basis for a common grading system applicable to squamous cell carcinomas of different anatomic sites.

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Section: Recently Proposed Grading System For Cervical Squamous Cell mentioning

confidence: 99%

Section: Recently Proposed Grading System For Cervical Squamous Cell mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

“…Proposed new grading system for squamous cell carcinoma of the cervix (Reproduced with permission from[3])…”

mentioning

confidence: 99%

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Towards developing a meaningful grading system for cervical squamous cell carcinoma

McCluggage

2018

The Journal of Pathology CR

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Tumour budding-based grading as independent prognostic biomarker in HPV-positive and HPV-negative head and neck cancer

et al. 2023

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Background The prognostic significance of tumour budding (TB) and minimal cell nest size (MCNS) was shown in human papillomavirus (HPV)-negative head and neck squamous cell carcinomas (HNSCC). However, the optimisation of cutpoints, the prognostic impact in HPV-positive HNSCC, and the comparison with other histopathological grading systems are insufficiently investigated. Methods TB and MCNS were analysed digitally in 1 and 10 high-power fields (HPF) of 331 HPV-positive and HPV-negative cases from TCGA. Optimising the cutpoints a new cellular dissociation grading (CDG) system was defined and compared to the WHO grading and the Brandwein–Gensler (BG) risk model. Results The two-tiered CDG system based solely on TB yielded optimal prognostic stratification with shortened overall survival for CDG-high cases. Optimal cut-offs were two buds (1 HPF) and six buds (10 HPF), respectively. Analysing MCNS did not add prognostic significance to quantifying TB. CDG was a significant prognostic marker in HPV-negative and HPV-positive tumours and prognostically superior to the WHO and BG systems. High CDG was associated with clinically occult lymph-node metastases. Conclusions The most comprehensive study of TB in HNSCC so far confirmed its prognostic impact in HPV-negative tumours and for the first time in HPV-positive tumours. Further studies are warranted to evaluate its applicability for therapy guidance in HNSCC.

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On Recurrence Detection of Squamous Cell Carcinoma of The Head and Neck; A Critical Survey

E¹

2021

SJO

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Current follow-up protocols of squamous cell carcinoma of the head and neck (SCCHN) rely on detection of recurrence at an asymptomatic stage. The evidence supporting a survival benefit of asymptomatic recurrence detection is relatively weak. These protocols are entirely based on assumptions and tradition, not evidence. There is ample evidence supporting the notion that most recurrences are diagnosed through patient symptoms. The staggering preponderance of symptomatic recurrence suggests that patients lack knowledge concerning symptoms that signify recurrence. Patient education should therefore be regarded a key factor of follow-up. We strongly emphasize the need for an easily accessible and adequate description of red flag symptoms that might signify recurrence. Having proper information, patients are less likely to forget, withhold or disregard these symptoms. Adequate incorporation of symptomatic recurrence might prove beneficial in terms of survival. Improvement of surveillance protocols for patients treated for SCCHN is of great concern considering the lives at stake, expense of treatment and follow-up. Local recurrence is the most important prognostic factor in SCCHN and incomplete surgical margins the single most decisive factor concerning recurrence. Local recurrence can arise close to the site of the initial primary tumor, either from cells left behind after surgery (minimal residual disease/cancer) and further deterioration of premalignant epithelial changes left behind after an excision. Several techniques have been developed for securing resection margins and identification of premalignant epithelial changes, thereby replacing the need for frozen sections. Genetic studies have unravelled the difference between local recurrence and secondary malignant tumors (SMTs) that necessitate significant changes in the timing and duration of follow-up appointments and renewed listing of SMTs. Conclusion:Today's simple 'one size fits all' surveillance protocols for SCCHN are inadequate. Rethinking of today's follow-up procedure is absolutely required.

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

Cited by 4 publications

References 0 publications

Towards developing a meaningful grading system for cervical squamous cell carcinoma

Towards developing a meaningful grading system for cervical squamous cell carcinoma

Tumour budding-based grading as independent prognostic biomarker in HPV-positive and HPV-negative head and neck cancer

On Recurrence Detection of Squamous Cell Carcinoma of The Head and Neck; A Critical Survey

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