The prognostic value of histopathologic grading parameters and microvessel density in patients with early squamous cell carcinoma of the uterine cervix.

Abstract

The purpose of this study was to investigate the prognostic importance of clinical and histopathologic factors, including malignancy grading systems (MGS), partial index (PI), invasive front grading (IFG), and microvessel density. A complete geographic series of 172 early stage (FIGO I-II) cervical carcinomas treated by Wertheim-Meigs surgery during the period 1965-1990 was studied. The patients were followed up for at least 10 years. Significant prognostic factors for disease-free survival were lymph node status (P < 0.0000001), radical surgical margins (P = 0.00003), and tumor size (P = 0.008). In a multivariate Cox analysis it was shown that lymph node status was the single most important prognostic factor with regard to disease-free survival. The total MGS and the PI scores were highly significantly (P = 0.0001) associated with pelvic lymph node metastases and disease-free survival rate in squamous cell carcinomas. The MGS and the PI systems were superior to the IFG system in predicting lymph node metastases. The total IFG score was also a statistically highly significant (P = 0.003) prognostic factor with regard to disease-free survival in both univariate and multivariate analyses. Microvessel density was a nonsignificant prognostic factor. There was a highly significant (P = 0.002) association between vascular space invasion of tumor cells and the presence of lymph node metastases. In conclusion, histopathologic malignancy grading systems provide valuable prognostic information in patients with early stage squamous cell carcinomas of the uterine cervix.

Combined external and intracavitary irradiation in treatment of advanced cervical carcinomas: Predictive factors for local tumor control and early recurrences

“…DNA ploidy and the malignancy grading score were not significantly associated with primary cure rate. This was in contrast to our earlier findings in surgically treated early stage cervical carcinomas where the malignancy grading system was a highly significant prognostic factor (36). As reported in other studies the hemoglobin value at start of therapy was a predictive factor for local tumor control (37).…”

“…As reported in other studies the hemoglobin value at start of therapy was a predictive factor for local tumor control (37). Tumor size was shown to be one of the most important predictive factors for tumor control in this series as well as in others (36). The importance of brachytherapy was shown by improved local control with increased number of brachytherapy fractions as well as increased brachytherapy dose and the total 2-Gy equivalent brachytherapy dose.…”

Metalloproteinase-2 expression correlates with aggressiveness of cutaneous squamous cell carcinomas

“…This immunohistochemical pattern was most pronounced at the invasive front, an area of the tumor that is particularly active in invasion and metastasis. [25][26][27] The correlation between intensely staining inflammatory infiltration and intensely staining tumor cells at the invasive front suggests an interaction, between inflammatory and tumor cells, which increases matrix metalloproteinase-2 expression and promotes tumor progression.…”

Intensity of cervical inflammatory reaction as a risk factor for recurrence of carcinoma of the uterine cervix in stages IB and IIA

“…20 The intensity of the infl ammatory reaction in the uterine cervix is considered in some scoring systems to be a risk factor for the recurrence of carcinoma of the uterine cervix, as in the Malignancy Grading System 10 and the Partial Index. 11 In these scoring systems, and also in others that are derived from them, 12,13,17,19 the absence of infl ammatory reaction or a slight reaction is implicated in greater recurrence risk. However, neither of these scoring systems is based on multivariate analysis to determine the intensity of the infl ammatory reaction as a risk factor for recurrence.…”