Prognostic significance of atypical mitotic figures in smooth muscle tumors of uncertain malignant potential (STUMP) of the uterus and uterine adnexa

Travaglino, Antonio; Raffone, Antonio; Santoro, Angela; Gencarelli, Annarita; Angelico, Giuseppe; Spadola, Saveria; Marzullo, Liberato; Zullo, Fulvio; Insabato, Luigi; Zannoni, Gian Franco

doi:10.1111/apm.13114

Cited by 7 publications

(4 citation statements)

References 29 publications

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“…AMF enumeration is a practical quantitative test that can be conducted in routine histological sections simultaneously with the MC and is thus of potential interest for routine histologic tumor prognostication. This study demonstrates the high prognostic value of the AMF count, the AMF to MF ratio, and the presence of multipolar AMFs for ccMCT, similar to previous studies on cancer in humans [ 15 , 16 , 18 , 19 , 20 , 21 ]. The value of AMF quantification at the proposed thresholds seems to be a high specificity and positive predictive value as compared to the MC due to a markedly lower number of false positives (cases with high values but without tumor-related death).…”

Section: Discussionsupporting

confidence: 88%

“…Few publications on neoplasms in humans have shown the prognostic value of AMFs for breast cancer [ 15 , 16 ], gastrointestinal stromal tumors [ 17 ], mesothelioma [ 18 ], pancreatic cancer [ 19 ], uterine smooth muscle tumors of uncertain malignant potential [ 20 ], and thyroid cancer [ 21 ]. These studies have correlated the presence or number of AMFs and/or the AMF to MF ratio with poor patient outcome.…”

Section: Introductionmentioning

confidence: 99%

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Atypical Mitotic Figures Are Prognostically Meaningful for Canine Cutaneous Mast Cell Tumors

Bertram,

Bartel,

Donovan

et al. 2023

Veterinary Sciences

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Cell division through mitosis (microscopically visible as mitotic figures, MFs) is a highly regulated process. However, neoplastic cells may exhibit errors in chromosome segregation (microscopically visible as atypical mitotic figures, AMFs) resulting in aberrant chromosome structures. AMFs have been shown to be of prognostic relevance for some neoplasms in humans but not in animals. In this study, the prognostic relevance of AMFs was evaluated for canine cutaneous mast cell tumors (ccMCT). Histological examination was conducted by one pathologist in whole slide images of 96 cases of ccMCT with a known survival time. Tumor-related death occurred in 11/18 high-grade and 2/78 low-grade cases (2011 two-tier system). The area under the curve (AUC) was 0.859 for the AMF count and 0.880 for the AMF to MF ratio with regard to tumor-related mortality. In comparison, the AUC for the mitotic count was 0.885. Based on our data, a prognostically meaningful threshold of ≥3 per 2.37 mm2 for the AMF count (sensitivity: 76.9%, specificity: 98.8%) and >7.5% for the AMF:MF ratio (sensitivity: 76.9%, specificity: 100%) is suggested. While the mitotic count of ≥ 6 resulted in six false positive cases, these could be eliminated when combined with the AMF to MF ratio. In conclusion, the results of this study suggests that AMF enumeration is a prognostically valuable test, particularly due to its high specificity with regard to tumor-related mortality. Additional validation and reproducibility studies are needed to further evaluate AMFs as a prognostic criterion for ccMCT and other tumor types.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Atypical Mitotic Figures Are Prognostically Meaningful for Canine Cutaneous Mast Cell Tumors

Bertram,

Bartel,

Donovan

et al. 2023

Veterinary Sciences

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“…This study was planned based on methods of previous systematic reviews [13][14][15]. Two independent authors performed all review stage; disagreements, if any, were resolved by consensus.…”

Section: Methodsmentioning

confidence: 99%

Prognostic predictors in recurrent adult granulosa cell tumors of the ovary: a systematic review and meta-analysis

Inzani

Santoro

Travaglino

et al. 2021

Arch Gynecol Obstet

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Background Ovarian adult granulosa cell tumours are low-grade malignant sex cord-stromal neoplasm with a low recurrence rate. Prognostic factors for recurrence include tumor stage, tumor rupture in Stage I neoplasms and the presence of residual tumors after surgery. However, in recurrent tumors, prognostic factors for overall survival (OS) are lacking. In the present paper, we conducted a systematic meta-analysis with the aim to assess prognostic factors for OS in patients with recurrent GCT. Methods Electronic databases were searched for all studies assessing prognostic factors in recurrent adult granulosa cell tumor of the ovary. Student T test, Fisher's exact test and Kaplan-Meier survival analysis with long-rank test were used to assess differences among groups; a p value < 0.05 was considered significant. Results Eleven studies analyzing 102 recurrent tumors were included in the systematic review. Tumor stage and localization of recurrent tumors were significantly associated with OS on Kaplan-Meier analysis; Cox regression analysis showed a HR of 0.879 for the stage II, of 3.052 for the stage III, and of 2.734 for stage IV tumor was significantly associated with OS (p = 0.037); observed HRs for abdominal and thoracic locations were of 2.405 and of 4.024, respectively. Conclusions In conclusion, the present article emphasizes the prognostic significance of tumor stage > II and extrapelvic anatomic sites of recurrences in patients with recurrent granuolase cell tumors of the ovary.

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“…A systematic review and a meta-analysis were carried out following previous studies [7][8][9]. Each step of the review process was performed by two independent authors, who sought consultation in the case of a disagreement.…”

Section: Methodsmentioning

confidence: 99%

Depth of Stromal Invasion as the Most Prognostically Relevant Regression System in Locally Advanced Cervical Cancer after Neoadjuvant Treatment: A Systematic Review and Meta-Analysis Grading

et al. 2021

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Background: several different criteria have been proposed to categorize the pathological response in cervical cancer after neoadjuvant therapy; although it is unclear what the most prognostically valuable one is. Objective: to assess the prognostic value of pathological criteria for categorizing the response in cervical cancer after neoadjuvant therapy, through a systematic review and meta-analysis. Methods: four electronic databases were searched from January to December 2020 for all studies, assessing the prognostic value of pathological response in cervical cancer after neoadjuvant therapy. Hazard ratio (HR) for overall survival (OS) was calculated with a significant p-value < 0.05. A meta-analysis was performed for each criteria assessed in at least three studies. Results: sixteen studies were included. Criteria for pathological response included (i) residual stromal invasion < vs. >3 mm; (ii) complete response vs. any residual; (iii) proportion of viable cells; (iv) residual tumor diameter; and (v) intracervical vs. extracervical residual. Criteria (i) and (ii) were suitable for meta-analysis. The presence of a residual tumor with stromal invasion > 3 mm showed a HR of 4.604 (95% CI; 3.229–6.565; p < 0.001), while the presence of any residual showed a HR of 1.610 (95% CI; 1.245–2.081; p < 0.001); statistical heterogeneity was absent in both analyses. Conclusions: dichotomizing the pathological response in cervical cancer after neoadjuvant therapy as < vs. >3 mm stromal invasion is more prognostically valuable than dichotomizing as complete response vs. any residual. Further studies are necessary to evaluate other systems.

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Prognostic significance of atypical mitotic figures in smooth muscle tumors of uncertain malignant potential (STUMP) of the uterus and uterine adnexa

Cited by 7 publications

References 29 publications

Atypical Mitotic Figures Are Prognostically Meaningful for Canine Cutaneous Mast Cell Tumors

Atypical Mitotic Figures Are Prognostically Meaningful for Canine Cutaneous Mast Cell Tumors

Prognostic predictors in recurrent adult granulosa cell tumors of the ovary: a systematic review and meta-analysis

Depth of Stromal Invasion as the Most Prognostically Relevant Regression System in Locally Advanced Cervical Cancer after Neoadjuvant Treatment: A Systematic Review and Meta-Analysis Grading

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