Grading ovarian serous carcinoma using a two tier system: Does it have prognostic significance?
DOI:
https://doi.org/10.7439/ijbar.v6i3.1852Keywords:
Serum calcium, Serum magnesium, Preeclampsia, Normal pregnancyAbstract
Background: A uniformly accepted, clinically useful grading system for ovarian serous carcinoma has not been defined. Objective: To evaluate a two tier system for grading of ovarian serous carcinoma as compared to the three tier system and to determine whether a predictive relationship exists between grade and survival. Methods: A retrospective collection of all cases of ovarian serous carcinomas diagnosed during five years in a tertiary care centre were chosen. The histopathological features were analysed and cases were categorised into two tier grading system as low grade and high grade, based primarily on the assessment of nuclear atypia with mitotic figures used as a secondary feature. For comparison, tumours were also graded using the system proposed by Shimizu/Silverberg and categorized as well, moderately and poorly differentiated. Median survival was calculated using the Kaplan-Meier method and the curves were compared using the log rank tests. Multivariate analysis was performed using Cox proportional hazard method. Contingency tables were used to compare the two grading systems. Results: Forty five cases of ovarian serous adenocarcinomas were studied and categorized into high grade (60%) and low grade (40%). For comparison, the cases were also graded using the Shimizu-Silverberg system and redistributed into grade 1, grade 2 and grade 3. When survival was modelled using a proportional hazard model with the two grading system as predictors, the p values for the two tier grading and Shimizu/Silverberg grading were p=0.62 and p=0.69 respectively. Conclusion: Significant difference was not noted in survival between low grade and high grade of two tier grading system and the three grades of Shimizu/Silverberg system. Majority of high grade carcinoma cases were placed in grade two of Shimizu/Silverberg grading system. Similarly, majority of cases of low grade carcinomas were placed in grade one of Shimizu/Silverberg grading system.Downloads
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