AI Article Synopsis
- In 2021, new guidelines were made for diagnosing and treating a type of cancer called uterine cervical carcinoma, updating rules from 2015.
- Pathologists now need to use a system that tells apart cancers caused by HPV from those that aren't, and look closely at how the cancer is growing.
- When studying the tumors, they need to make sure to check all parts carefully, especially if the tumor is bigger than 2 cm, and follow specific rules for surgeries and testing the lymph nodes.
Article Abstract
In 2021, the 2015 German consensus guideline for the diagnosis and treatment of uterine cervical carcinoma was updated. The present article summarises the new recommendations for pathologists: the incorporation of the International Endocervical Adenocarcinoma Classification (IECC), which morphologically separates HPV-associated and non-HPV-associated adenocarcinomas, as well as the reporting of the prognostic relevant growth pattern of the adenocarcinoma of the endocervical subtype (Silva pattern). Histologically, multifocality has been defined as the presence of clearly invasive foci with a minimum distance between each focus of 0.2 cm. Because of its intratumoural heterogeneity, all carcinomas ≤ 2 cm in their largest dimension should be processed completely, and tumours > 2 cm should be processed with one block per centimetre of their greatest dimension. In cases of (radical) trachelectomy/hysterectomy, the distal vaginal resection margin and all parametrial tissue should be processed completely. Sentinel lymph nodes have to be processed completely by lamellation along its long axis in 0.2 cm intervals. Immunohistochemical ultrastaging is mandatory. Staging should be performed using the 2009 FIGO classification and 2017 TNM classification. Reporting the revised 2018 FIGO classification is optional. To date, molecular markers have not been relevant for prognostication and treatment decision making.
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| http://dx.doi.org/10.1007/s00292-021-01051-3 | DOI Listing |
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