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Association between Silva pattern-based classification and endocervical adenocarcinoma: a systematic review and
Mengmeng Chen1, Ling Han1, Yisi Wang1
1Department of Obstetrics and Gynecology, Sichuan University West China Second University Hospital, Chengdu, Sichuan, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University West China Second University Hospital, Chengdu, Sichuan, China.
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
- Cancer Prognostics
Background:
- Endocervical adenocarcinoma is a significant gynecologic malignancy.
- Accurate prognostic markers are crucial for guiding treatment decisions.
- The Silva pattern-based classification system has emerged as a potential tool for risk stratification.
Purpose of the Study:
- To systematically review and meta-analyze the correlation between the Silva pattern-based classification system and the prognosis of endocervical adenocarcinoma.
- To evaluate the association between Silva patterns and clinicopathological features, including survival and recurrence rates.
Main Methods:
- A systematic literature search was conducted across PubMed, Embase, Cochrane Library, and Web of Science from January 2013 to March 2024.
- Eligible studies investigating the Silva classification system's impact on endocervical adenocarcinoma prognosis were included.
- Data from 19 studies encompassing 3122 cases were pooled for meta-analysis.
Main Results:
- Silva A pattern showed a 0% death rate and 0.1% recurrence rate, with no lymphovascular invasion.
- Silva B pattern was associated with a 2.6% death rate, 5.1% recurrence rate, and 21.0% lymphovascular invasion.
- Silva C pattern demonstrated a 14.0% death rate, 19.4% recurrence rate, and 58.8% lymphovascular invasion, with a lower FIGO I rate.
Conclusions:
- The Silva pattern-based classification system is a valuable tool for predicting the prognosis of human papillomavirus (HPV)-related endocervical adenocarcinoma.
- Silva A is negatively correlated with mortality, while Silva C is positively correlated, offering significant prognostic information.
- This classification system can assist clinicians in guiding patient treatment strategies for endocervical adenocarcinoma.
