Chemotherapy Response Score: Development and Validation of a System to Quantify Histopathologic Response to Neoadjuvant Chemotherapy in Tubo-Ovarian High-Grade Serous Carcinoma
Chemotherapy Response Score: Development and Validation of a System to Quantify Histopathologic Response to Neoadjuvant Chemotherapy in Tubo-Ovarian High-Grade Serous Carcinoma
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DOI：
10.1200/jco.2014.60.5212
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发表时间：
2015-08-01
影响因子：
45.3
通讯作者：
Singh, Naveena
中科院分区：
文献类型：
--
作者：
Boehm, Steffen;Faruqi, Asma;Singh, Naveena
PurposeTo开发和验证一个组织病理学评分系统，用于测量响应新辅助化疗的间隔减瘤手术标本的IIIC至IV期输卵管卵巢高级别serous carcinoma.Patients and MethodsA六层组织病理学评分系统提出并应用于一个测试队列（TC）的62例新辅助化疗和间隔减瘤手术治疗。附件和网膜切片由三位病理学家独立评分。TC结果的基础上，一个三层化疗反应评分（CRS）系统的开发和应用到一个独立的验证队列71 patients.ResultsThe初始系统显示中等interobserver重现性和预后分层TC患者时，适用于网膜，但不适用于附件。浓缩到一个三级评分，该系统是高度可重复的（kappa，0.75）。校正年龄、分期和减积状态后，该评分预测无进展生存期（PFS;评分2 v3;中位PFS，11.3 v32.1个月;校正风险比，6.13; 95%CI，2.13 - 17.68; P <0.001）。应用于验证队列的网膜样本的三层CRS系统显示出高重现性（kappa，0.67）和预测的PFS（CRS 1和2 v3：中位数，12 v18个月;校正的风险比，3.60; 95%CI，1.69至7.66; P <0.001）。CRS 3还预测了对一线铂类药物治疗的敏感性（进展< 6个月的阴性预测值为94.3%）。建立了一个网站，以培训病理学家使用CRS system.ConclusionThe CRS系统是可重复的，并显示高级别浆液性癌的预后意义。国际癌症报告协作组织提议在国际病理学报告中实施该系统，该系统可能对患者护理和研究产生潜在影响。(C)2015年美国临床肿瘤学会
PurposeTo develop and validate a histopathologic scoring system for measuring response to neoadjuvant chemotherapy in interval debulking surgery specimens of stage IIIC to IV tubo-ovarian high-grade serous carcinoma.Patients and MethodsA six-tier histopathologic scoring system was proposed and applied to a test cohort (TC) of 62 patients treated with neoadjuvant chemotherapy and interval debulking surgery. Adnexal and omental sections were independently scored by three pathologists. On the basis of TC results, a three-tier chemotherapy response score (CRS) system was developed and applied to an independent validation cohort of 71 patients.ResultsThe initial system showed moderate interobserver reproducibility and prognostic stratification of TC patients when applied to the omentum but not to the adnexa. Condensed to a three-tier score, the system was highly reproducible (kappa, 0.75). When adjusted for age, stage, and debulking status, the score predicted progression-free survival (PFS; score 2 v 3; median PFS, 11.3 v 32.1 months; adjusted hazard ratio, 6.13; 95% CI, 2.13 to 17.68; P < .001). The three-tier CRS system applied to omental samples from the validation cohort showed high reproducibility (kappa, 0.67) and predicted PFS (CRS 1 and 2 v 3: median, 12 v 18 months; adjusted hazard ratio, 3.60; 95% CI, 1.69 to 7.66; P < .001). CRS 3 also predicted sensitivity to first-line platinum therapy (94.3% negative predictive value for progression < 6 months). A Web site was established to train pathologists to use the CRS system.ConclusionThe CRS system is reproducible and shows prognostic significance for high-grade serous carcinoma. Implementation in international pathology reporting has been proposed by the International Collaboration on Cancer Reporting, and the system could potentially have an impact on patient care and research. (C) 2015 by American Society of Clinical Oncology