The Silva Pattern-based Classification for HPV-associated Invasive Endocervical Adenocarcinoma

Background

• Silva pattern-based classification for human papilloma virus–associated invasive adenocarcinoma
  • Reliable system to predict risk of lymph node metastasis and recurrences
  • Synoptic reports
    • College of American Pathologists (CAP)
    • International Collaboration on Cancer Reporting (ICCR)
  • National Comprehensive Cancer Network (NCCN) guidelines
    • “emergent concept”

::: aside International Journal of Gynecological Pathology: March 2021 - Volume 40 - Issue - p S48-S65 :::

Definitions

Clinico-pathologic features

Pattern A

Pattern B

Pattern C

Algorithm

Treatment

• Pattern A
  • Conservatively with conization with negative margins and no lymph node dissection
• Pattern B with LVI
  • SLN mapping or limited LN sampling
• Pattern C
  • Standard surgical treatment including SLN sampling or LN dissection