Cargando…

Endometrial Carcinoma Diagnosis: Use of FIGO Grading and Genomic Subcategories in Clinical Practice: Recommendations of the International Society of Gynecological Pathologists

In this review, we sought to address 2 important issues in the diagnosis of endometrial carcinoma: how to grade endometrial endometrioid carcinomas and how to incorporate the 4 genomic subcategories of endometrial carcinoma, as identified through The Cancer Genome Atlas, into clinical practice. The...

Descripción completa

Detalles Bibliográficos
Autores principales: Soslow, Robert A., Tornos, Carmen, Park, Kay J., Malpica, Anais, Matias-Guiu, Xavier, Oliva, Esther, Parkash, Vinita, Carlson, Joseph, McCluggage, W. Glenn, Gilks, C. Blake
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6295928/
https://www.ncbi.nlm.nih.gov/pubmed/30550484
http://dx.doi.org/10.1097/PGP.0000000000000518
_version_ 1783380943228108800
author Soslow, Robert A.
Tornos, Carmen
Park, Kay J.
Malpica, Anais
Matias-Guiu, Xavier
Oliva, Esther
Parkash, Vinita
Carlson, Joseph
McCluggage, W. Glenn
Gilks, C. Blake
author_facet Soslow, Robert A.
Tornos, Carmen
Park, Kay J.
Malpica, Anais
Matias-Guiu, Xavier
Oliva, Esther
Parkash, Vinita
Carlson, Joseph
McCluggage, W. Glenn
Gilks, C. Blake
author_sort Soslow, Robert A.
collection PubMed
description In this review, we sought to address 2 important issues in the diagnosis of endometrial carcinoma: how to grade endometrial endometrioid carcinomas and how to incorporate the 4 genomic subcategories of endometrial carcinoma, as identified through The Cancer Genome Atlas, into clinical practice. The current International Federation of Gynecology and Obstetrics grading scheme provides prognostic information that can be used to guide the extent of surgery and use of adjuvant chemotherapy or radiation therapy. We recommend moving toward a binary scheme to grade endometrial endometrioid carcinomas by considering International Federation of Gynecology and Obstetrics defined grades 1 and 2 tumors as “low grade” and grade 3 tumors as “high grade.” The current evidence base does not support the use of a 3-tiered grading system, although this is considered standard by International Federation of Gynecology and Obstetrics, the American College of Obstetricians and Gynecologists, and the College of American Pathologists. As for the 4 genomic subtypes of endometrial carcinoma (copy number low/p53 wild-type, copy number high/p53 abnormal, polymerase E mutant, and mismatch repair deficient), which only recently have been identified, there is accumulating evidence showing these categories can be reproducibly diagnosed and accurately assessed based on biopsy/curettage specimens as well as hysterectomy specimens. Furthermore, this subclassification system can be adapted for current clinical practice and is of prognostic significance independent of conventional variables used for risk assessment in patients with endometrial carcinoma (eg, stage). It is too soon to recommend the routine use of genomic classification in this setting; however, with further evidence, this system may become the basis for the subclassification of all endometrial carcinomas, supplanting (partially or completely) histotype, and grade. These recommendations were developed from the International Society of Gynecological Pathologists Endometrial Carcinoma project.
format Online
Article
Text
id pubmed-6295928
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Lippincott Williams & Wilkins
record_format MEDLINE/PubMed
spelling pubmed-62959282018-12-26 Endometrial Carcinoma Diagnosis: Use of FIGO Grading and Genomic Subcategories in Clinical Practice: Recommendations of the International Society of Gynecological Pathologists Soslow, Robert A. Tornos, Carmen Park, Kay J. Malpica, Anais Matias-Guiu, Xavier Oliva, Esther Parkash, Vinita Carlson, Joseph McCluggage, W. Glenn Gilks, C. Blake Int J Gynecol Pathol Articles In this review, we sought to address 2 important issues in the diagnosis of endometrial carcinoma: how to grade endometrial endometrioid carcinomas and how to incorporate the 4 genomic subcategories of endometrial carcinoma, as identified through The Cancer Genome Atlas, into clinical practice. The current International Federation of Gynecology and Obstetrics grading scheme provides prognostic information that can be used to guide the extent of surgery and use of adjuvant chemotherapy or radiation therapy. We recommend moving toward a binary scheme to grade endometrial endometrioid carcinomas by considering International Federation of Gynecology and Obstetrics defined grades 1 and 2 tumors as “low grade” and grade 3 tumors as “high grade.” The current evidence base does not support the use of a 3-tiered grading system, although this is considered standard by International Federation of Gynecology and Obstetrics, the American College of Obstetricians and Gynecologists, and the College of American Pathologists. As for the 4 genomic subtypes of endometrial carcinoma (copy number low/p53 wild-type, copy number high/p53 abnormal, polymerase E mutant, and mismatch repair deficient), which only recently have been identified, there is accumulating evidence showing these categories can be reproducibly diagnosed and accurately assessed based on biopsy/curettage specimens as well as hysterectomy specimens. Furthermore, this subclassification system can be adapted for current clinical practice and is of prognostic significance independent of conventional variables used for risk assessment in patients with endometrial carcinoma (eg, stage). It is too soon to recommend the routine use of genomic classification in this setting; however, with further evidence, this system may become the basis for the subclassification of all endometrial carcinomas, supplanting (partially or completely) histotype, and grade. These recommendations were developed from the International Society of Gynecological Pathologists Endometrial Carcinoma project. Lippincott Williams & Wilkins 2019-01 2018-12-14 /pmc/articles/PMC6295928/ /pubmed/30550484 http://dx.doi.org/10.1097/PGP.0000000000000518 Text en Copyright © 2018 International Society of Gynecological Pathologists. Published by Wolters Kluwer Health, Inc. on behalf of the International Society of Gynecological Pathologists. This is an open access article distributed under the Creative Commons Attribution License 4.0 (http://creativecommons.org/licenses/by/4.0/) (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0/
spellingShingle Articles
Soslow, Robert A.
Tornos, Carmen
Park, Kay J.
Malpica, Anais
Matias-Guiu, Xavier
Oliva, Esther
Parkash, Vinita
Carlson, Joseph
McCluggage, W. Glenn
Gilks, C. Blake
Endometrial Carcinoma Diagnosis: Use of FIGO Grading and Genomic Subcategories in Clinical Practice: Recommendations of the International Society of Gynecological Pathologists
title Endometrial Carcinoma Diagnosis: Use of FIGO Grading and Genomic Subcategories in Clinical Practice: Recommendations of the International Society of Gynecological Pathologists
title_full Endometrial Carcinoma Diagnosis: Use of FIGO Grading and Genomic Subcategories in Clinical Practice: Recommendations of the International Society of Gynecological Pathologists
title_fullStr Endometrial Carcinoma Diagnosis: Use of FIGO Grading and Genomic Subcategories in Clinical Practice: Recommendations of the International Society of Gynecological Pathologists
title_full_unstemmed Endometrial Carcinoma Diagnosis: Use of FIGO Grading and Genomic Subcategories in Clinical Practice: Recommendations of the International Society of Gynecological Pathologists
title_short Endometrial Carcinoma Diagnosis: Use of FIGO Grading and Genomic Subcategories in Clinical Practice: Recommendations of the International Society of Gynecological Pathologists
title_sort endometrial carcinoma diagnosis: use of figo grading and genomic subcategories in clinical practice: recommendations of the international society of gynecological pathologists
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6295928/
https://www.ncbi.nlm.nih.gov/pubmed/30550484
http://dx.doi.org/10.1097/PGP.0000000000000518
work_keys_str_mv AT soslowroberta endometrialcarcinomadiagnosisuseoffigogradingandgenomicsubcategoriesinclinicalpracticerecommendationsoftheinternationalsocietyofgynecologicalpathologists
AT tornoscarmen endometrialcarcinomadiagnosisuseoffigogradingandgenomicsubcategoriesinclinicalpracticerecommendationsoftheinternationalsocietyofgynecologicalpathologists
AT parkkayj endometrialcarcinomadiagnosisuseoffigogradingandgenomicsubcategoriesinclinicalpracticerecommendationsoftheinternationalsocietyofgynecologicalpathologists
AT malpicaanais endometrialcarcinomadiagnosisuseoffigogradingandgenomicsubcategoriesinclinicalpracticerecommendationsoftheinternationalsocietyofgynecologicalpathologists
AT matiasguiuxavier endometrialcarcinomadiagnosisuseoffigogradingandgenomicsubcategoriesinclinicalpracticerecommendationsoftheinternationalsocietyofgynecologicalpathologists
AT olivaesther endometrialcarcinomadiagnosisuseoffigogradingandgenomicsubcategoriesinclinicalpracticerecommendationsoftheinternationalsocietyofgynecologicalpathologists
AT parkashvinita endometrialcarcinomadiagnosisuseoffigogradingandgenomicsubcategoriesinclinicalpracticerecommendationsoftheinternationalsocietyofgynecologicalpathologists
AT carlsonjoseph endometrialcarcinomadiagnosisuseoffigogradingandgenomicsubcategoriesinclinicalpracticerecommendationsoftheinternationalsocietyofgynecologicalpathologists
AT mccluggagewglenn endometrialcarcinomadiagnosisuseoffigogradingandgenomicsubcategoriesinclinicalpracticerecommendationsoftheinternationalsocietyofgynecologicalpathologists
AT gilkscblake endometrialcarcinomadiagnosisuseoffigogradingandgenomicsubcategoriesinclinicalpracticerecommendationsoftheinternationalsocietyofgynecologicalpathologists