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Lv Y, Wang N, Liu Y, Li X, Fan L, Li M, Wang L, Yu Z, Yan Q, Guo Y, Guo S, Wei L, Shi M, Wang Z. Tumor invasion depth is a useful pathologic assessment for predicting outcomes in cervical squamous cell carcinoma after neoadjuvant radiotherapy. Diagn Pathol 2015; 10:200. [PMID: 26537362 PMCID: PMC4632273 DOI: 10.1186/s13000-015-0426-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 10/09/2015] [Indexed: 11/30/2022] Open
Abstract
Background To evaluate whether tumor invasion depth can be a reliable and easily applicable pathologic assessment strategy to predict outcomes using surgically resected cervical squamous cell carcinoma specimens from patients who have received neoadjuvant radiotherapy (RT) or concurrent chemoradiotherapy (CCRT). Methods We included 173 patients with cervical squamous cell carcinoma who received neoadjuvant CCRT (n = 125) or RT (n = 48) and underwent subsequent radical hysterectomy. Data for the pre-operative clinical International Federation of Gynecology and Obstetrics (FIGO) stage, post-operative pathologic FIGO stage, World Health Organization (WHO) double diameter measurement evaluation, response evaluation criteria in solid tumors (RECIST 1.1) criteria, tumor necrosis rate (TNR), and tumor regression grade (TRG) were investigated to identify correlations with outcomes related to distant metastasis and survival. The tumor invasion depth (TID) and the tumor invasion depth with cytokeratin immunostaining correction (TIDC) at the cervical internal surface were measured to assess their relations to patients’ outcomes. Results Based on measurements taken via transvaginal ultrasound, the pre-operative clinical and post-operative pathologic FIGO staging as well as the WHO double diameter measurement evaluation and RECIST 1.1 criteria were predictive of distant metastasis and survival-related outcomes. Also, lymph node involvement was found to be an independent prognostic factor for recurrence and distant metastasis. Finally, univariate analysis showed both the TID and TIDC were highly related to distant metastasis, overall survival, and progression-free survival, irrespective of the clinical stage of carcinomas. Conclusion The TID or TIDC measured at the cervical internal surface is a useful and easily applied pathologic prognostic factor for distant metastasis and survival outcomes in patients with cervical squamous cell carcinoma treated with neoadjuvant RT or CCRT. Electronic supplementary material The online version of this article (doi:10.1186/s13000-015-0426-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yang Lv
- State Key Laboratory of Cancer Biology, Department of Pathology Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, 710032, P.R. China
| | - Ning Wang
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, 710032, P.R. China
| | - Yixiong Liu
- State Key Laboratory of Cancer Biology, Department of Pathology Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, 710032, P.R. China
| | - Xia Li
- State Key Laboratory of Cancer Biology, Department of Pathology Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, 710032, P.R. China
| | - Linni Fan
- State Key Laboratory of Cancer Biology, Department of Pathology Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, 710032, P.R. China
| | - Mingyang Li
- State Key Laboratory of Cancer Biology, Department of Pathology Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, 710032, P.R. China
| | - Lu Wang
- State Key Laboratory of Cancer Biology, Department of Pathology Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, 710032, P.R. China
| | - Zhou Yu
- State Key Laboratory of Cancer Biology, Department of Pathology Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, 710032, P.R. China
| | - Qingguo Yan
- State Key Laboratory of Cancer Biology, Department of Pathology Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, 710032, P.R. China
| | - Ying Guo
- State Key Laboratory of Cancer Biology, Department of Pathology Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, 710032, P.R. China
| | - Shuangping Guo
- State Key Laboratory of Cancer Biology, Department of Pathology Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, 710032, P.R. China
| | - Lichun Wei
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, 710032, P.R. China.
| | - Mei Shi
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, 710032, P.R. China.
| | - Zhe Wang
- State Key Laboratory of Cancer Biology, Department of Pathology Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, 710032, P.R. China.
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