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  • 1
    Electronic Resource
    Electronic Resource
    Quantitative pathologic features as predictors of long-term survival in patients with advanced ovarian cancer treated with cisplatin (1994)
    238 Main Street, Cambridge, Massachusetts 02142, USA : Blackwell Scientific Publications
    International journal of gynecological cancer 4 (1994), S. 0 
    Details
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The prognostic value of morphometric and DNA flow cytometric features were studied and compared with FIGO stage, preoperative tumor load, residual disease status, Karnofsky index and classic pathologic features such as Broders’ grade and histologic type in 58 FIGO stage III and IV adequately debulked ovarian patients with long-term follow-up. The mitotic activity index, volume percentage of epithelium, and mean and SD of nuclear area were assessed by interactive morphometry, and tumor material was routinely processed for DNA flow cytometric assessment of DNA ploidy and S-phase fraction. Survival analysis (Kaplan-Meier curves, Mantel-Cox test), revealed FIGO stage (P = 0.013) and the mean and SD of nuclear area to be significant prognosticators (P = 0.027 and P = 0.012, respectively). In multivariate survival analysis (Cox model), a multivariate combination of FIGO stage, preoperative tumor load and mean nuclear area was the best prognostic combination of features (P = 0.0034). These results confirm the findings of previous studies. We conclude that, in accord with previous studies, morphometric features are good predictors of survival after cisplatin treatment in advanced ovarian cancer, especially in combination with FIGO stage and preoperative tumor load.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1525-1438.1994.04030174.x
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  • 2
    Electronic Resource
    Electronic Resource
    In Dutch and Danish patients with FIGO III ovarian carcinoma, geographic survival differences are associated with differences in quantitative pathologic features (1996)
    Suite 500, 5th Floor, 238 Main Street, Cambridge, Massachussets 02142, USA : Blackwell Science Inc.
    International journal of gynecological cancer 6 (1996), S. 0 
    Details
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: In a previous investigation, a group of Danish FIGO III and IV ovarian cancer patients from Aarhus were found to have more aggressive tumor characteristics compared with Dutch patients, concerning histologic grade, morphometric features and residual disease status. The aim of the present investigation was to investigate possible geographic differences in clinicopathologic and quantitative prognostic features in a large group of Dutch and Danish patients only with FIGO III ovarian carcinoma, from Copenhagen and to compare the survival of these two groups. One hundred and sixty-nine patients were included in the current investigation, all were treated with debulking surgery followed by cisplatin combination chemotherapy. Dutch patients (42% survived, median survival time 48 months) had a significantly better survival than the Danish patients (33% survived, median survival time 27 months) (Mantel-Cox (MC) = 6.0, P = 0.01). In the subgroup with residual disease larger than 2 cm, survival differences were even more striking: survival was 32% in Dutch patients (median survival time 24 months) and 15% in Danish patients (median survival time, 16 months). Logistic regression analysis revealed that the geographic survival difference was associated with differences in the morphometric feature mean nuclear area (MNA). The MNA was significantly larger in the Danish ovarian tumors (78 µm2 vs 63 µm2). With a cut-off point for MNA of 75 µm2, survival was similar for the Dutch and Danish patients with values below and also for those above that value, but Danish patients had many more values above 75 µm2. Therefore, the MNA is a useful prognosticator in patients with FIGO III ovarian cancer treated with cisplatin combination chemotherapy, especially since this variable is not susceptible to geographic differences. The reason for the difference in MNA, and consequently worse survival in Danish patients, remains to be elucidated.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1525-1438.1996.06020108.x
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  • 3
    Electronic Resource
    Electronic Resource
    Confirmation of the prognostic value of the ECPI-1 score (myometrial invasion, DNA-ploidy and mean shortest nuclear axis) in FIGO stage I endometrial cancer patients with long follow-up (1995)
    Suite 500, 5th Floor, 238 Main Street, Cambridge, Massachussetts 02142, USA : Blackwell Science Inc.
    International journal of gynecological cancer 5 (1995), S. 0 
    Details
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: In FIGO stage I endometrial cancer patients, histologic type and grade are correlated with prognosis and used for therapeutic decision making. However, assessment of these histologic features is subjective, and the results are not always perfectly reproducible. Contrarily, previous studies have shown that DNA-ploidy and morphometric features are highly reproducible and have a strong prognostic value in these cancers. Multivariate analysis has demonstrated that a combination of mean shortest nuclear axis (MSNA), DNA-ploidy and depth of myometrial invasion (the so-called ECPI-1 score) overshadowed the value of all other features investigated. The present study was set up to evaluate further and compare the prognostic power of the ECPI-1 score in 77 FIGO I patients with long follow-up (10–15 years). Grade (revised), invasion depth, MSNA and ploidy were all highly significant. However, the ECPI-1 score (with exactly the same threshold as in the previous study, 0.87) greatly exceeded the prognostic value of these single features. Only two (3%) of the 64 patients with ECPI-1 〈inlineGraphic alt="leqslant R: less-than-or-eq, slant" extraInfo="nonStandardEntity" href="urn:x-wiley:1048891X:IJG05020112:les" location="les.gif"/〉0.87 died (at 14 and 62 months), in contrast to 11 (84.6%) of the 13 cases with ECPI-1〉 0.87 (10 died within 42 months) (P 〈 0.0001, Mantel-Cox value = 51.1). These results confirm the prognostic strength of the ECPI-1 score in stage I endometrial carcinoma.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1525-1438.1995.05020112.x
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  • 4
    Electronic Resource
    Electronic Resource
    A Histopathological Contribution to Supratentorial Glioma Grading, Definition of Mixed Gliomas and Recognition of Low Grade Glioma With Rosenthal Fibers (2000)
    Springer
    Journal of neuro-oncology 46 (2000), S. 23-43 
    Details
    ISSN: 1573-7373
    Keywords: Cox regression ; prognosis ; gliomas ; oligodendrocytes ; mitoses ; Rosenthal fibers
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background Previous glioma studies have described separate grading systems for oligodendrogliomas and astrocytomas. Many of these gliomas contain mixtures of neoplastic astrocytes and oligodendrocytes. Prognosis may be related to the percentages of these neoplastic components. Previous survival/grading studies have been limited to histopathological features but have not evaluated the importance of percentages of neoplastic components. This study attempted to perceive the relative importance of percentages of neoplastic astrocytes and oligodendrocytes for definition of astroglial, oligodendroglial and mixed oligoastroglial tumors. After determination of these limits we explored the possibility to develop a grading system for common supratentorial gliomas based on reproducible histopathological features. Methods A retrospective study was performed of 362 cases of unselected supratentorial glioma. One hundred and thirty-eight binary and nine continuous histopathological variables, amongst which percentages of neoplastic astrocytes and oligodendrocytes, were scored and related to survival. Only well reproducible histological features were accepted in Cox regression to define glioma grades. Results and conclusions Supratentorial gliomas appeared to be composed of variable percentages of neoplastic oligodendrocytes and astrocytes, but this spectrum did not correspond to a continuous change in prognosis. Gliomas containing 30% or more neoplastic oligodendrocytes had a slightly better outcome (p 〈 0.0432) but higher percentages did not further improve prognosis. Percentages of neoplastic astrocytes were not correlated to survival. We therefore propose to designate gliomas containing 30% or more neoplastic oligodendrocytes as oligodendroglial tumors, and others as astroglial tumors. From a prognostic point of view there is no need to recognize mixedbreak oligoastrocytomas. An interesting finding was the recognition of a low grade glioma group with Rosenthal fibers, which had the longest postoperative survival. Another prognosticator of interest concerns the mitotic rate as a continuous variable. Atypical mitoses indicated the worst survival, after necrosis. It was possible to develop a grading system for all supratentorial gliomas using six reproducible histological parameters: necrosis, atypical mitoses, the mitotic rate, endothelial proliferative activity, percentage of neoplastic oligodendrocytes and Rosenthal fibers. This resulted in four grades for astroglial tumors (p 〈 0.002) and three grades for oligodendroglial tumors (p 〈 0.008) which differed significantly within each group with respect to survival.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1006496328729
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