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Updated: Jun 12, 2025

Sentinel Lymph Node Mapping and Biopsy for Endometrial Cancer at Early Stage with Laparoscopy

Sentinel Lymph Node Mapping and Biopsy for Endometrial Cancer at Early Stage with Laparoscopy

Published on: August 19, 2021

Identification of low-risk cases of invasive endocervical adenocarcinoma with Silva pattern-based classification: a

Nikita Sinha¹, Olivia D Lara¹, Kimberly Dessources¹

¹Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA.

Gynecologic Oncology Reports

|June 10, 2025

Summary

This summary is machine-generated.

The Silva classification system effectively predicts invasive endocervical adenocarcinoma (EAC) outcomes. Pattern A indicates a low risk of metastasis, recurrence, and death, while patterns B and C show intermediate and high risks, respectively.

Keywords:

Endocervical adenocarcinoma Lymph node metastasis Pathology Silva classification system Silva pattern of invasion

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Last Updated: Jun 12, 2025

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Area of Science:

Gynecologic Oncology
Pathology
Cancer Prognostics

Background:

Invasive endocervical adenocarcinoma (EAC) classification is crucial for predicting patient outcomes.
The Silva pattern-based classification system offers a potential method for risk stratification in EAC.

Purpose of the Study:

To evaluate the discriminatory ability of the Silva pattern-based classification system in predicting lymph node (LN) metastasis, recurrence, and death in patients with EAC.
To establish distinct risk profiles for EAC based on Silva patterns A, B, and C.

Main Methods:

Systematic literature search of PubMed, Scopus, and Embase up to 2024 for studies on EAC classified by Silva patterns.
Inclusion of studies reporting outcomes of LN metastasis, recurrence, or death.
Random-effects meta-analysis to summarize binomial proportions and compare outcomes between Silva patterns.

Main Results:

19 studies with 2998 patients were analyzed: 20.8% pattern A, 23.1% pattern B, 54.1% pattern C.
Silva pattern A showed significantly lower risks of LN metastasis (0.6%) compared to pattern B (6.1%) and pattern C (22.0%).
Pattern A cases had distinctly low risks (0.3%) for recurrence and death, significantly lower than patterns B/C. Pattern B showed lower risks than pattern C for all outcomes.

Conclusions:

The Silva classification system is highly predictive of oncologic outcomes in EAC, with distinct low (A), intermediate (B), and high (C) risk profiles.
The low-risk profile of pattern A may support de-escalation of surgical and adjuvant treatments.
Pattern C cases might benefit from consideration of adjuvant treatment escalation.