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163 Cervical adenocarcinoma: clinical implications of the risk stratification system (silva system)
  1. G Devoto1,
  2. F Falcon2,
  3. F Garcia Kamermann2,
  4. S Alessandria1,
  5. J Lange1,
  6. G Torres1,
  7. S Tatti1 and
  8. A Bermudez1
  1. 1Buenos Aires University Hospital, Gynecologic Oncology Unit, Buenos Aires, Argentina
  2. 2Buenos Aires University Hospital, Pathology Department, Buenos Aires, Argentina


Objectives To correlate the Silva system with prognosis and outcome.

Methods 32 patients with cervical adenocarcinoma were included between 6–90 and 10–16. Median age was 43 years. Median follow-up was 66 months. Slides from surgical specimens were classified by two pathologists. Results were correlated with: tumor size, FIGO staging, site of recurrence, DFS and OS.

Results Twelve patients (37%) had pattern A tumors; all stage I and with no lymph node metastases (LNM) or recurrences. Pattern B was seen in 13 tumors (41%); all stage I, LNM was seen in 2 (15%). One patient had a local recurrence in this group (8%). Pattern C was found in 7 cases (22%), all with LVI. Five (71%) showed LNM and recurrences were recorded in 4 (57%). Tumor size was: <2 cm A: 8 (66%), B: 2 (15%), C: 0 (0%) and = o >2 cm A: 4 (34%), B: 11 (85%) and C: 7 (100%). DFS was: A=73 months, B=76 months, C=58 and the OS was: A=55 months, B=79 months, C=62 months. One Pattern C tumor presented ovarian involvement. The only 2 distant recurrences were Pattern C patients.

Conclusions There is a relation between FIGO staging, DFS and OS. In our series, Pattern C tumors seem to have higher incidence of nodal involvement and local and distant recurrences.

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