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Association between Silva pattern-based classification and endocervical adenocarcinoma: a systematic review and
Mengmeng Chen1,2, Ling Han1,2, Yisi Wang1,2
1Department of Obstetrics and Gynecology, Sichuan University West China Second University Hospital, Chengdu, Sichuan, China.
Summary
The Silva classification system effectively predicts prognosis in human papillomavirus (HPV)-related endocervical adenocarcinoma. Silva A indicates a lower death rate, while Silva C correlates with a higher risk, aiding treatment guidance.
Area of Science:
- Gynecologic Oncology
- Pathology
- Medical Imaging
Background:
- Endocervical adenocarcinoma prognosis is crucial for patient management.
- The Silva pattern-based classification system offers a potential tool for risk stratification.
Purpose of the Study:
- To determine the relationship between the Silva pattern-based classification system and the prognosis of endocervical adenocarcinoma.
- To evaluate the predictive value of Silva patterns for patient outcomes.
Main Methods:
- Systematic literature search of PubMed, Embase, Cochrane Library, and Web of Science (January 2013 - March 2024).
- Inclusion of 19 studies with 3122 cases for systematic review and meta-analysis.
- Analysis of combined death rates, recurrence rates, lymphovascular invasion, and FIGO stage I based on Silva patterns (A, B, C).
Main Results:
- Silva A pattern showed a 0% combined death rate and 0.1% recurrence rate.
- Silva C pattern was associated with a 14.0% death rate and 19.4% recurrence rate.
- Lymphovascular invasion rates were 0% for Silva A, 21.0% for Silva B, and 58.8% for Silva C.
Conclusions:
- The Silva pattern-based classification system is a significant predictor of prognosis in endocervical adenocarcinoma.
- Silva A is negatively correlated with mortality, while Silva C is positively correlated.
- This system can assist in guiding patient treatment strategies for HPV-related endocervical adenocarcinoma.
Keywords:
Adenocarcinoma
