Clinicopathologic association and prognostic value of MELF pattern in invasive endocervical adenocarcinoma (ECA) as Classified by IECC Journal Article
| Authors: | Segura, S. E.; Hoang, L.; Boros, M.; Terinte, C.; Pesci, A.; Aviel-Ronen, S.; Kiyokawa, T.; Alvarado-Cabrero, I.; Oliva, E.; Park, K. J.; Soslow, R. A.; Stolnicu, S. |
| Article Title: | Clinicopathologic association and prognostic value of MELF pattern in invasive endocervical adenocarcinoma (ECA) as Classified by IECC |
| Abstract: | Microcystic, elongated, and fragmented (MELF) pattern of myometrial invasion is correlated with lymphovascular invasion (LVI) and lymph node metastases in uterine endometrioid carcinoma but has not been described in endocervical adenocarcinoma (ECA). A total of 457 ECAs were collected, and clinical/morphologic parameters correlated with follow-up data. Potential associations between MELF pattern and age, human papillomavirus status, tumor size/grade, LVI, lymph node metastases, Silva pattern were analyzed. Statistical analyses of overall survival (OS), disease-free survival, progression-free survival (PFS) were conducted using Kaplan-Meier analysis, and compared using the Log-rank test. Of 292 ECAs analyzed, 94 (32.19%) showed MELF invasion pattern (MELF-positive). Significant statistical correlation was found between MELF-positive and tumor size (P=0.0017), LVI (P=0.007), Silva pattern (P=0.0005); age, human papillomavirus status, tumor grade, lymph node metastases did not correlate. Fifty-five of 292 patients recurred (18.83%): 18/94 (19.14%) MELF-positive, 37/198 (18.68%) MELF-negative. PFS in MELF-positive: 77.2% and 64.5% at 5 and 10 yr, respectively; PFS in MELF-negative: 82% and 68.5% at 5 and 10 yr, respectively. On multivariate analysis for PFS and other prognostic parameters, only LVI was statistically significant (P=0.001). OS in MELF-positive was 86% and 74.1% at 5 and 10 yr, respectively; OS in MELF-negative, was 89.7% and 86% at 5 and 10 yr, respectively. Median survival was worse in MELF-positive (199.8 mo) versus MELF-negative (226.1 mo); this was not statistically significant. On multivariate analysis for OS and other prognostic parameters, only tumor stage was statistically significant (P=0.002). In ECAs, MELF is not independently associated with survival. Pathologic characteristics of MELF-positive (size, LVI, Silva pattern) versus MELF-negative tumors differ significantly. © 2020 Lippincott Williams and Wilkins. All rights reserved. |
| Keywords: | microcystic; endocervical adenocarcinoma; elongated, and fragmented (melf) pattern; silva pattern |
| Journal Title: | International Journal of Gynecological Pathology |
| Volume: | 39 |
| Issue: | 5 |
| ISSN: | 0277-1691 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2020-09-01 |
| Start Page: | 436 |
| End Page: | 442 |
| Language: | English |
| DOI: | 10.1097/pgp.0000000000000633 |
| PUBMED: | 31517653 |
| PROVIDER: | scopus |
| PMCID: | PMC7064387 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 October 2020 -- Source: Scopus |
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