MELF Pattern for Predicting Lymph Node Involvement and Survival in Grade I-II Endometrioid-type Endometrial Cancer.
The aim of this study was to examine the associations between microcystic, elongated, and fragmented (MELF) pattern and other prognostic factors and lymph node involvement, disease-free survival, and overall survival (OS) using a case-control group consisting of grade I-II endometrioid endometrial carcinoma (EEC) patients with/without lymph node involvement. The files of the patients were searched electronically for all hysterectomy specimens with a diagnosis of grade I-II EEC of the uterine body from January 1, 2008 to July 31, 2014. Lymph node involvement was detected in 27 patients who were histologically diagnosed with grade I-II EEC, and these patients made up the case group. Using a dependent random sampling method, 28 grade I-II EEC patients without lymph node involvement were selected. According to multivariate regression analysis, lymphovascular space invasion [odds ratio, 23.5; 95% confidence interval (CI), 2.4-223.5] and MELF pattern (odds ratio, 13.3; 95% CI, 1.4-121.8) were significant predictors of lymph node involvement. There was recurrence in 15.8% of cases that showed a MELF pattern and in 19.4% of those that did not (P=0.738). According to Kaplan-Meier analysis, the MELF pattern revealed no significant differences in disease-free survival (hazard ratio, 1.0; 95% CI, 0.1-36.5), whereas the effect on OS was significant (hazard ratio, 2.2; 95% CI, 1.3-4.2). The presence of MELF pattern was a substantial risk factor for detecting lymph node involvement in patients with grade I-II EEC. The MELF pattern may be important for identifying which patients need staging surgery, in addition to its effect on the OS.
Departments of Gynecologic Oncology (M.S.) Obstetrics and Gynecology (V.G., M.K., O.G.) Pathology (T.K.), Tepecik Education and Research Hospital, Izmir Department of Gynecologic Oncology, Muğla Sitki Koçman University Education and Research Hospital, Muğla (K.G.) Department of Gynecologic Oncology, Bakirköy Dr. Sadi Konuk Education and Research Hospital, İstanbul (I.A.O.), Turkey.
Muzaffer
M
Sanci
Kemal
K
Güngördük
Varol
V
Gülseren
Tuğba
T
Karadeniz
Mustafa
M
Kocaer
Ozgu
O
Gungorduk
İsa A
İA
Özdemir
D000368:Aged; D001706:Biopsy; D018269:Carcinoma, Endometrioid / Q000175:diagnosis / Q000401:mortality / Q000473:pathology*; D016022:Case-Control Studies; D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors