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Prognostic impact of histological review of high-grade endometrial carcinomas in a large Danish cohort.
Boennelycke, Marie; Peters, Elke E M; Léon-Castillo, Alicia; Smit, Vincent T H B M; Bosse, Tjalling; Christensen, Ib Jarle; Ørtoft, Gitte; Høgdall, Claus; Høgdall, Estrid.
Afiliación
  • Boennelycke M; Department of Pathology, Copenhagen University Hospital, Herlev and Gentofte Hospital, Copenhagen University, Borgmester Ib Juuls Vej 73, 2730, Herlev, Denmark. marie.boennelycke@regionh.dk.
  • Peters EEM; Department of Pathology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.
  • Léon-Castillo A; Department of Pathology, Haaglanden Medical Center, P.O. Box 432, 2501 CK, The Hague, The Netherlands.
  • Smit VTHBM; Department of Pathology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.
  • Bosse T; Department of Pathology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.
  • Christensen IJ; Department of Pathology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.
  • Ørtoft G; Department of Pathology, Copenhagen University Hospital, Herlev and Gentofte Hospital, Copenhagen University, Borgmester Ib Juuls Vej 73, 2730, Herlev, Denmark.
  • Høgdall C; Department of Gynecology, Copenhagen University Hospital, Rigshospitalet, Juliane Maries Vej 8, 2100, Copenhagen, OE, Denmark.
  • Høgdall E; Department of Gynecology, Copenhagen University Hospital, Rigshospitalet, Juliane Maries Vej 8, 2100, Copenhagen, OE, Denmark.
Virchows Arch ; 479(3): 507-514, 2021 Sep.
Article en En | MEDLINE | ID: mdl-34117532
The aim of this study was to investigate the outcome of histological subtype review of high-grade endometrial carcinoma (EC) and its prognostic impact in a large well-documented Danish nationwide cohort. From the Danish Gynecological Cancer Database (DGCD) 2005-2012 cohort, we included 425 patients with an original diagnosis of high-grade EC, independent of histologic subtype. Of these, at least one hematoxylin and eosin (H&E)-stained slide from 396 cases (93.2%) was available for review. The histologic subtype was reviewed by specialized gynecopathologists blinded to the original diagnosis and clinical outcome. Interobserver variability between original and revised histologic subtypes was analyzed using simple Kappa statistics. Hazard ratios (HR), recurrence-free survival (RFS), and overall survival were calculated for original and revised subtypes, respectively. Overall histologic subtype agreement was moderate (kappa = 0.42) with the highest agreement for endometrioid-type EC (EEC; 75.5%) and serous-type EC (SEC; 63.8%). For clear cell carcinoma and un-/dedifferentiated EC, agreement was significantly lower: 30.1% and 33.3% respectively. Of the 396 reviewed cases, only two (0.5%) were re-classified as low-grade EEC upon revision. Interestingly, GR3 EEC had better RFS than SEC with stronger significance after revision (HR 2.36 (95% CI 1.43-3.89), p = 0.001), compared to original diagnosis (HR 1.74 (95% CI 1.07-2.81), p = 0.024). In conclusion, this study confirmed that pathology review results in substantial shift in histological subtype in high-grade EC. After review, a stronger prognostic benefit for GR3 EEC as compared to other histological subtypes was observed. This work supports maintaining a low threshold for pathology revision of high-grade EC in clinical practice.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Carcinoma / Neoplasias Endometriales Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Middle aged País/Región como asunto: Europa Idioma: En Revista: Virchows Arch Asunto de la revista: BIOLOGIA MOLECULAR / PATOLOGIA Año: 2021 Tipo del documento: Article País de afiliación: Dinamarca Pais de publicación: Alemania
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Carcinoma / Neoplasias Endometriales Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Middle aged País/Región como asunto: Europa Idioma: En Revista: Virchows Arch Asunto de la revista: BIOLOGIA MOLECULAR / PATOLOGIA Año: 2021 Tipo del documento: Article País de afiliación: Dinamarca Pais de publicación: Alemania