Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Jun;129(6):283-290.
doi: 10.1111/apm.13135. Epub 2021 Apr 13.

Stanford parameters stratify the risk of recurrence in gynecologic smooth muscle tumors of uncertain malignant potential

Antonio Travaglino  1 , Antonio Raffone  2 , Annarita Gencarelli  1 , Carola Caldarelli  2 , Marcello Granata  2 , Angela Santoro  3 , Gian Franco Zannoni  3 , Antonio Mollo  4 , Fulvio Zullo  2 , Luigi Insabato  1
Affiliations
Review

Stanford parameters stratify the risk of recurrence in gynecologic smooth muscle tumors of uncertain malignant potential

Antonio Travaglino et al. APMIS. 2021 Jun.

Abstract

Smooth muscle tumor of uncertain malignant potential (STUMP) is an ill-defined category of neoplasms, which represent a diagnostic challenge. We aimed to assess whether the Stanford parameters, that is, high mitotic index (≥10/10HPF), significant atypia (moderate-to-severe), and coagulative tumor cell necrosis (CTCN), even when focal or ambiguous, may be used to stratify the risk of recurrence in gynecological smooth muscle tumor of uncertain malignant potential (STUMP). Electronic databases were searched from their inception to October 2019. All studies assessing the Stanford parameters in gynecological STUMP series were included. STUMPs were subdivided according to the presence of the three Stanford parameters: high mitotic index, significant atypia, and CTCN. A Kaplan-Meier survival analysis was performed for recurrence-free survival; hazard ratio (HR) was calculated in each category. Fourteen studies with 219 STUMPs were included. In 15.5% of cases, none of the three Stanford parameters were present, with a recurrence risk of 5.9%; 2.7% of cases showed high mitotic index alone, with a recurrence risk of 0% (HR = not calculable); 43.8% of cases showed significant atypia alone, with a recurrence risk of 18.7% (HR = 3.3; p = 0.012); 26.5% of cases showed CTCN alone, with a recurrence risk of 17.2% (HR = 3.1; p = 0.029); and 11.4% of cases showed at least two Stanford parameters, with a recurrence risk of 32% (HR = 7.5; p = 0.003). Stanford parameters may stratify the risk of recurrence of STUMP. Significant atypia and CTCN, but not high mitotic index, may be stand-alone risk factors for recurrence in STUMP. The presence of at least two Stanford parameters, even if equivocal (e.g., uncertain or focal CTCN, focal significant atypia, mitotic index around 10/10HPF), might still be enough to support a diagnosis of leiomyosarcoma. Further studies are necessary in this field.

Keywords: Prognosis; diagnosis; leiomyoma; myoma; myomata; sarcoma.

PubMed Disclaimer

References

REFERENCES

    1. Stewart EA. Uterine fibroids. Lancet. 2001;357:293-8.
    1. Mazzei P, Piccolo A, Nugnes L, Mascolo M, De Rosa G, Staibano S. Metabolic profile of intact tissue from uterine leiomyomas using high-resolution magic-angle-spinning 1H NMR spectroscopy. NMR Biomed. 2010;23:1137-45.
    1. De Falco M, Staibano S, Mascolo M, Mignogna C, Improda L, Ciociola F, et al. Leiomyoma pseudocapsule after pre-surgical treatment with gonadotropin-releasing hormone agonists: relationship between clinical features and immunohistochemical changes. Eur J Obstet Gynecol Reprod Biol 2009;144:44-7.
    1. De Falco M, Staibano S, D'Armiento FP, et al. Preoperative treatment of uterine leiomyomas: clinical findings and expression of transforming growth factor-beta3 and connective tissue growth factor. J Soc Gynecol Investig 2006;13(4):297-303.
    1. Kurman R, Carcangiu M, Herrington C, Young R. World Health Organisation Classification of Tumors of Female Reproductive Organs, 4th edn. Lyon, France: International Agency for Research on Cancer (IARC) Press; 2014.

LinkOut - more resources