Reproducibility of measurement of myometrial invasion in endometrial carcinoma

Putten, Louis J.M. van der; Vijver, Koen Van de; Bartosch, Carla; Davidson, Ben; Gatius, Sònia; Matías‐Guiu, Xavier; McCluggage, W. Glenn; Toledo, Gemma; Wurff, A.A.M. van der; Pijnenborg, Johanna M.A.; Massuger, Leon F.A.G.; Bulten, Johan

doi:10.1007/s00428-016-2035-5

Cited by 13 publications

(12 citation statements)

References 26 publications

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“…With this study, we add to previous studies regarding reproducibility of pathological reporting of other EC specific characteristics such as histological typing, tumour grading, assessment of cervical involvement and assessment of myometrial invasion. [32][33][34][35] Levels of reproducibility of these tumour characteristics are similar to our results for LVSI assessment. None of the previous studies specifically focused on LVSI assessment, but there are two studies that report on reproducibility of LVSI in EC.…”

Section: Discussionsupporting

confidence: 86%

Reproducibility of lymphovascular space invasion (LVSI) assessment in endometrial cancer

et al. 2019

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AimsLymphovascular space invasion (LVSI) in endometrial cancer (EC) is an important prognostic variable impacting on a patient's individual recurrence risk and adjuvant treatment recommendations. Recent work has shown that grading the extent of LVSI further improves its prognostic strength in patients with stage I endometrioid EC. Despite this, there is little information on the reproducibility of LVSI assessment in EC. Therefore, we designed a study to evaluate interobserver agreement in discriminating true LVSI from LVSI mimics (Phase I) and reproducibility of grading extent of LVSI (Phase II).Methods and resultsScanned haematoxylin and eosin (H&E) slides of endometrioid EC (EEC) with a predefined possible LVSI focus were hosted on a website and assessed by a panel of six European gynaecological pathologists. In Phase I, 48 H&E slides were included for LVSI assessment and in Phase II, 42 H&E slides for LVSI grading. Each observer was instructed to apply the criteria for LVSI used in daily practice. The degree of agreement was measured using the two‐way absolute agreement average‐measures intraclass correlation coefficient (ICC). Reproducibility of LVSI assessment (ICC = 0.64, P < 0.001) and LVSI grading (ICC = 0.62, P < 0.001) in EEC was substantial among the observers.ConclusionsGiven the good reproducibility of LVSI, this study further supports the important role of LVSI in decision algorithms for adjuvant treatment.

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Section: Discussionsupporting

confidence: 86%

Reproducibility of lymphovascular space invasion (LVSI) assessment in endometrial cancer

et al. 2019

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“…Chattopadhyay et al (10) demonstrated that TFD is an independent predictor of disease specific survival, recurrence and pelvic lymph node involvement. Data regarding the cut-off value of TFD in patients with endometrial cancer which revealed the best predictive performance value varied between 1,75 and 10 mm (7,14). In the current study, only >50% MI was found to have a predictive value for cervical involvement, type 2 and LVSI.…”

Section: Discussionmentioning

confidence: 43%

“…To our knowledge, this is the first study demonstrating the superiority of MI compared to TFD and DMI in predicting EC outcomes. This can be explained by the reduced number of patients included in this study compared with other study (11,14). Besides, the lack of equitable distribution of histological types with a large predominance of endometroid carcinoma seems to influence the results of the study.…”

Section: Discussionmentioning

confidence: 83%

“…There was no statistically significant result for the correlation between DOI, TFD and clinicopathologic parameters. As far as the reproductibility of measurement of myometrial invasion is concerned, the best agreement is reached when measuring %MI and TFD according to van der Putten et al (14). Myometrial invasion is sometimes affected by confounding factors, including the irregularity of the endomyometrial junction, the extension of the tumour into adenomyotic foci, exophytic tumours, leiomyomas and different patter ns of myometrial invasion (15,16).…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of tumor‑free distance and depth of myometrial invasion as prognostic factors in endometrial cancer

et al. 2018

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Abstract. The aim of the study was to investigate whether the tumor free distance (TFD), which is the distance in millimeters between the deepest point of invasion and the serosal surface, and absolute depth of invasion (DMI), the distance in millimeters between the endomyometrial junction and the deepest point of myometrial invasion, are useful in surgical staging and in predicting prognosis. The present study retrospectively analyzed 62 cases of endometrial carcinoma with complete surgical staging, carried out over a 4 and half-year period (January 2003 to June 2007). All surgicopathological findings including surgical stages, histological type and grade, myometrial invasion, lymphovascular space invasion, cervical and adnexal involvement, and lymph node metastasis were abstracted from medical records and pathological reports. Univariate and multivariate analyses were performed comparing TFD, DMI and the percentage of mypmetrial invasion (MI) with established prognostic factors. A total of 62 patients were included in the study. A total of 52 (84%) had endometrioid carcinomas and 31 patients (60%) had grade 1 cancer. The deepest MI was <50% in 32 patients (52%). Median DMI was 2.7 mm (range 0-15 mm). Median TFD was 3 mm (range 0-19 mm). There was lymphovascular space invasion (LVSI) in 11 patients (17.5%), cervical involvement in 11 patients (17.5%), extra-uterine extension in 9 cases (14%) and lymph node metastasis in 12 patients (22%). It was demonstrated that 50% MI was significantly associated with prognostic factors (cervical involvement, type 2 carcinomas and LVSI, and was a significant predictor of the 5-year overall survival rate and recurrence-free survival (P=0.05, P=0.01). No significant association was observed between DMI and TFD with clinicopathological parameters and survival rates. The importance of DMI in predicting recurrence of disease was observed to be highest in terms of sensitivity and specificity. The cut-off value with the highest sensitivity and specificity crossing the receive operating characteristic curve was calculated to be 3 mm for DMI and 2.5 mm for TFD. The results indicate that DMI is a superior predictive factor of recurrence of the disease compared with TFD. However, further studies are required in order to prove the prognostic usefulness of these parameters and then to improve management of endometrial cancer. IntroductionEndometrial carcinoma is the most common of all the gynecologic malignancies and its incidence is rising (1,2). Surgical staging is an important determinant of adjuvant therapy. Whilst most patients with early stage disease have a good prognosis, the prognosis for patients with recurrent or advanced disease at presentation, i.e., advanced stage, incurable by surgery or radiotherapy, is poor. The most important parameter to elaborate the surgical stage is the depth of myometrial invasion (3,4). The percentage of myometrial invasion (%MI) is routinely determined in hysterectomy specimens and categorized as greater than or less than 50% and it is one of the ...

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“…As FIGO stage I disease is the most frequently seen endometrial cancer [5], myometrial invasion depth is one of the most important indicators that clinicians and pathologists investigate. Although there are many studies assessing the importance of myometrial invasion (MI) using a cut-off limit as 50% of MI [6][7][8][9], there are limited number of studies evaluating tumor-free distance (TFD) to the serosa [5,10,11]. Moreover, most of them evaluated TFD for prediction for lymph node metastasis but the long-term follow-up is taken into consideration in only few studies [12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Is Tumor-Free Distance an Independent Prognostic Factor for Early-Stage Endometrioid Endometrial Cancer?

Öge

Kavak

Çakmak

et al. 2020

Journal of Oncology

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ere are many studies assessing the importance of myometrial invasion using a cut-off limit as 50% of myometrial invasion for endometrial cancer, and there are a limited number of studies evaluating tumor-free distance to the serosa. To evaluate the prognostic performance of tumor-free distance and percentage of myometrial invasion in patients with stage IB endometrioid endometrial cancer, we retrospectively evaluated 133 patients diagnosed and treated as stage IB endometrioid endometrial cancer. Tumor-free distance was assessed, and recurrence and recurrence-free survival were analyzed. Nine patients had recurrent disease (6.8%). Recurrence-free survival was 200 months. Two patients died because of malignancy. In the Cox regression model according to tumor-free distance, depth of invasion, and percentage of myometrial invasion, it was seen that none of these parameters were significant to predict the recurrence (p > 0.05). In conclusion, tumor-free distance is not an independent prognostic factor for patients with stage IB endometrioid endometrial cancer.

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Reproducibility of measurement of myometrial invasion in endometrial carcinoma

Cited by 13 publications

References 26 publications

Reproducibility of lymphovascular space invasion (LVSI) assessment in endometrial cancer

Reproducibility of lymphovascular space invasion (LVSI) assessment in endometrial cancer

Evaluation of tumor‑free distance and depth of myometrial invasion as prognostic factors in endometrial cancer

Is Tumor-Free Distance an Independent Prognostic Factor for Early-Stage Endometrioid Endometrial Cancer?

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