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Ahmed Q, Hussein Y, Hayek K, Bandyopadhyay S, Semaan A, Abdul-Karim F, Al-Wahab Z, Munkarah AR, Elshaikh MA, Alosh B, Nucci MR, Van de Vijver KK, Morris RT, Oliva E, Ali-Fehmi R. Is the two-tier ovarian serous carcinoma grading system potentially useful in stratifying uterine serous carcinoma? A large multi-institutional analysis. Gynecol Oncol 2013; 132:372-6. [PMID: 24262874 DOI: 10.1016/j.ygyno.2013.11.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Revised: 11/07/2013] [Accepted: 11/11/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE A subset of uterine serous carcinoma (USC) may have better clinical behavior bringing up the possibility that there may be morphologic features, which would help in their categorization. The aim of this study is to evaluate the potential use of the MD Anderson Cancer Center 2-tier grading system for ovarian carcinoma in USC. METHODS Tumors assigned a combined score included in this analysis were 1) low-grade: tumors without marked atypia and 12 mitoses/10 high power field (HPF) and 2) high grade: tumors with severe nuclear atypia and >12 mitoses/10 HPF. Clinicopathologic parameters evaluated included patients' age, tumor size, myometrial invasion (MI), lymphovascular invasion (LVI), lymph node (LN), FIGO stage, and patient outcome. RESULTS 140 patients with USC were included, 30 low grade uterine serous carcinoma (LGUSC) and 110 high grade uterine serous carcinoma (HGUSC). Of all parameters only 2 (MI and stage IA) reached statistical significance. 67% of LGUSC cases showed myometrial invasion versus 93.6% HGUSC cases (p = 0.003). A higher percentage of LGUSC (63.3%) versus HGUSC (32.7%) were in stage IA (p = 0.01). However, by multivariate analysis including age, LVI, stage and tumor grade only stage was an independent prognostic factor. CONCLUSION The presence of atypia and mitosis across a uterine serous carcinoma is notoriously variable in magnitude and extent, potentially making evaluation of these features difficult and subsequent grading subjective. Our findings thus show that actual prognostic utility of application of MDACC two-tier grading system to uterine serous carcinoma may not be applicable.
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Affiliation(s)
- Quratulain Ahmed
- Wayne State University, Harper University Hospital, Department of Pathology, 3990 John R. Street, Detroit, MI 48201, USA.
| | - Yaser Hussein
- Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065, USA.
| | - Kinda Hayek
- Wayne State University, Harper University Hospital, Department of Pathology, 3990 John R. Street, Detroit, MI 48201, USA.
| | - Sudeshna Bandyopadhyay
- Wayne State University, Harper University Hospital, Department of Pathology, 3990 John R. Street, Detroit, MI 48201, USA.
| | - Assaad Semaan
- Karmanos Cancer institute, 4100 John R St, Detroit, MI 48201, USA.
| | - Fadi Abdul-Karim
- Cleveland Clinic Main Campus, Mail Code L25, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
| | - Zaid Al-Wahab
- Karmanos Cancer institute, 4100 John R St, Detroit, MI 48201, USA.
| | - Adnan R Munkarah
- Henry Ford Health System, 2799 W Grand Blvd, Detroit, MI 48202, USA.
| | | | - Baraa Alosh
- Wayne State University, Harper University Hospital, Department of Pathology, 3990 John R. Street, Detroit, MI 48201, USA.
| | - Marisa R Nucci
- Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.
| | | | - Robert T Morris
- Karmanos Cancer institute, 4100 John R St, Detroit, MI 48201, USA.
| | - Esther Oliva
- Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, USA.
| | - Rouba Ali-Fehmi
- Wayne State University, Harper University Hospital, Department of Pathology, 3990 John R. Street, Detroit, MI 48201, USA.
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