Steffen Böhm1, Asma Faruqi2, Ian Said2, Michelle Lockley2, Elly Brockbank2, Arjun Jeyarajah2, Amanda Fitzpatrick2, Darren Ennis2, Thomas Dowe2, Jennifer L Santos2, Linda S Cook2, Anna V Tinker2, Nhu D Le2, C Blake Gilks2, Naveena Singh2. 1. Steffen Böhm, Asma Faruqi, Ian Said, Michelle Lockley, Elly Brockbank, Arjun Jeyarajah, Amanda Fitzpatrick, and Naveena Singh, Barts Health National Health Service Trust; Steffen Böhm, Michelle Lockley, Darren Ennis, and Thomas Dowe, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom; Jennifer L. Santos, Anna V. Tinker, and Nhu D. Le, British Columbia Cancer Agency; C. Blake Gilks, University of British Columbia, Vancouver, BC, Canada; and Linda S. Cook, University of New Mexico, Albuquerque, NM. steffen.boehm@bartshealth.nhs.uk. 2. Steffen Böhm, Asma Faruqi, Ian Said, Michelle Lockley, Elly Brockbank, Arjun Jeyarajah, Amanda Fitzpatrick, and Naveena Singh, Barts Health National Health Service Trust; Steffen Böhm, Michelle Lockley, Darren Ennis, and Thomas Dowe, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom; Jennifer L. Santos, Anna V. Tinker, and Nhu D. Le, British Columbia Cancer Agency; C. Blake Gilks, University of British Columbia, Vancouver, BC, Canada; and Linda S. Cook, University of New Mexico, Albuquerque, NM.
Abstract
PURPOSE: To develop and validate a histopathologic scoring system for measuring response to neoadjuvant chemotherapy in interval debulking surgery specimens of stage IIIC to IV tubo-ovarian high-grade serous carcinoma. PATIENTS AND METHODS: A six-tier histopathologic scoring system was proposed and applied to a test cohort (TC) of 62 patients treated with neoadjuvant chemotherapy and interval debulking surgery. Adnexal and omental sections were independently scored by three pathologists. On the basis of TC results, a three-tier chemotherapy response score (CRS) system was developed and applied to an independent validation cohort of 71 patients. RESULTS: The initial system showed moderate interobserver reproducibility and prognostic stratification of TC patients when applied to the omentum but not to the adnexa. Condensed to a three-tier score, the system was highly reproducible (kappa, 0.75). When adjusted for age, stage, and debulking status, the score predicted progression-free survival (PFS; score 2 v 3; median PFS, 11.3 v 32.1 months; adjusted hazard ratio, 6.13; 95% CI, 2.13 to 17.68; P < .001). The three-tier CRS system applied to omental samples from the validation cohort showed high reproducibility (kappa, 0.67) and predicted PFS (CRS 1 and 2 v 3: median, 12 v 18 months; adjusted hazard ratio, 3.60; 95% CI, 1.69 to 7.66; P < .001). CRS 3 also predicted sensitivity to first-line platinum therapy (94.3% negative predictive value for progression < 6 months). A Web site was established to train pathologists to use the CRS system. CONCLUSION: The CRS system is reproducible and shows prognostic significance for high-grade serous carcinoma. Implementation in international pathology reporting has been proposed by the International Collaboration on Cancer Reporting, and the system could potentially have an impact on patient care and research.
PURPOSE: To develop and validate a histopathologic scoring system for measuring response to neoadjuvant chemotherapy in interval debulking surgery specimens of stage IIIC to IV tubo-ovarian high-grade serous carcinoma. PATIENTS AND METHODS: A six-tier histopathologic scoring system was proposed and applied to a test cohort (TC) of 62 patients treated with neoadjuvant chemotherapy and interval debulking surgery. Adnexal and omental sections were independently scored by three pathologists. On the basis of TC results, a three-tier chemotherapy response score (CRS) system was developed and applied to an independent validation cohort of 71 patients. RESULTS: The initial system showed moderate interobserver reproducibility and prognostic stratification of TCpatients when applied to the omentum but not to the adnexa. Condensed to a three-tier score, the system was highly reproducible (kappa, 0.75). When adjusted for age, stage, and debulking status, the score predicted progression-free survival (PFS; score 2 v 3; median PFS, 11.3 v 32.1 months; adjusted hazard ratio, 6.13; 95% CI, 2.13 to 17.68; P < .001). The three-tier CRS system applied to omental samples from the validation cohort showed high reproducibility (kappa, 0.67) and predicted PFS (CRS 1 and 2 v 3: median, 12 v 18 months; adjusted hazard ratio, 3.60; 95% CI, 1.69 to 7.66; P < .001). CRS 3 also predicted sensitivity to first-line platinum therapy (94.3% negative predictive value for progression < 6 months). A Web site was established to train pathologists to use the CRS system. CONCLUSION: The CRS system is reproducible and shows prognostic significance for high-grade serous carcinoma. Implementation in international pathology reporting has been proposed by the International Collaboration on Cancer Reporting, and the system could potentially have an impact on patient care and research.
Authors: N M de Lange; N P M Ezendam; J S Kwon; I Vandenput; D Mirchandani; F Amant; L J M van der Putten; J M A Pijnenborg Journal: Curr Oncol Date: 2019-04-01 Impact factor: 3.677
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Authors: Alexi A Wright; Kari Bohlke; Deborah K Armstrong; Michael A Bookman; William A Cliby; Robert L Coleman; Don S Dizon; Joseph J Kash; Larissa A Meyer; Kathleen N Moore; Alexander B Olawaiye; Jessica Oldham; Ritu Salani; Dee Sparacio; William P Tew; Ignace Vergote; Mitchell I Edelson Journal: J Clin Oncol Date: 2016-08-08 Impact factor: 44.544