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- Title
Reproducibility of measurement of myometrial invasion in endometrial carcinoma.
- Authors
Davidson, Ben; van der Putten, Louis; Massuger, Leon; van de Vijver, Koen; Bartosch, Carla; Gatius, Sonia; Matias-Guiu, Xavier; McCluggage, W.; Toledo, Gemma; van der Wurff, Anneke; Pijnenborg, Johanna; Bulten, Johan; van der Putten, Louis J M; McCluggage, W Glenn; van der Wurff, Anneke A M; Pijnenborg, Johanna M A; Massuger, Leon F A G
- Abstract
Myometrial invasion (MI) as a percentage (%MI), categorized into <50 or ≥50 %, is an important predictor of prognosis in endometrial carcinoma. Recent studies suggest that tumor-free distance (TFD) to serosa and the absolute depth of invasion (DOI) might be stronger predictors of prognosis. Although reproducibility is important in clinical practice for patient prognostication and treatment, reproducibility of these methods for the measurement of MI is largely unknown. One or two slides from 50 patients with FIGO stage I endometrioid endometrial carcinoma were viewed by seven gynecological pathologists, who were requested to measure %MI, TFD, and DOI. We categorized %MI as <50 % (including no MI) or ≥50 %, TFD as ≤1.75 or >1.75 mm (including no MI), ≤7 or >7 mm (including no MI), and ≤10 or >10 mm (including no MI) and DOI as <4 mm (including no MI) or ≥4 mm. Light's kappa for multi-rater agreement was calculated. The %MI, TFD, and DOI could be measured in 88, 83, and 79 % of cases, respectively. Kappa was 0.75 for %MI, 0.77, 0.73, and 0.69 respectively for TFD with cutoffs of 1.75, 7, and 10 mm, and 0.59 for DOI. Pathologists reach substantial agreement when measuring %MI and TFD and moderate agreement when measuring DOI. The %MI can be measured in more cases than TFD and DOI. This supports the use of %MI in daily clinical practice, but future studies should compare %MI and TFD more extensively, including inter-observer variability.
- Subjects
UTERINE contraction; PROGNOSIS; ENDOMETRIAL cancer; CARCINOMA; PHYSICIAN practice patterns; DIAGNOSIS; CANCER relapse; CANCER invasiveness; RESEARCH evaluation; TUMOR classification; ENDOMETRIAL tumors; RESEARCH bias
- Publication
Virchows Archiv: European Journal of Pathology, 2017, Vol 470, Issue 1, p63
- ISSN
0945-6317
- Publication type
journal article
- DOI
10.1007/s00428-016-2035-5