{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T04:22:56Z","timestamp":1773980576918,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,3,28]],"date-time":"2024-03-28T00:00:00Z","timestamp":1711584000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare the pelvic lymph node involvement and risk of recurrence in patients with human papillomavirus (HPV)\u2010associated endocervical adenocarcinoma stage IA2\u2010IB1 undergoing hysterectomy and\/or trachelectomy plus lymphadenectomy, according to Silva's classification system.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort study was performed in two Colombian cancer centers. The cases were classified according to the Silva classification system. Clinical, surgical, and histopathological variables were evaluated. Recurrence risk was analyzed by patterns A, B, or C. A logistic regression model was performed for tumor recurrence. The Kaplan\u2013Meier method was used to estimate overall survival and disease\u2010free survival (DFS). A weighted kappa was performed to determine the degree of concordance between pathologists.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 100 patients were identified, 33% pattern A, 29% pattern B, and 38% pattern C. The median follow\u2010up time was 42.5\u2009months. No evidence of lymph node involvement was found in patients classified as A and B, while in the C pattern was observed in 15.8% (<jats:italic>n<\/jats:italic>\u2009=\u20096) of cases (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01). There were 7% of cases with recurrent disease, of which 71.5% corresponded to type C pattern. Patients with Silva pattern B and C had 1.22\u2010 and 4.46\u2010fold increased risk of relapse, respectively, compared with pattern A. The 5\u2010year DFS values by group were 100%, 96.1%, and 80.3% for patterns A, B, and C, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>For patients with early\u2010stage HPV\u2010associated endocervical adenocarcinoma, the type C pattern presented more lymph node involvement and risk of recurrence compared to the A and B patterns. The concordance in diagnosis of different Silva's patterns by independents pathologists were good.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.15482","type":"journal-article","created":{"date-parts":[[2024,3,28]],"date-time":"2024-03-28T14:45:18Z","timestamp":1711637118000},"page":"1232-1239","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Pelvic lymph node involvement and risk of recurrence in <scp>HPV<\/scp>\u2010associated endocervical adenocarcinoma stage <scp>IA2\u2010IB1<\/scp> according to Silva's system in two Colombian cancer centers"],"prefix":"10.1002","volume":"166","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0384-5725","authenticated-orcid":false,"given":"Jairo Alonso","family":"Hern\u00e1ndez","sequence":"first","affiliation":[{"name":"Department of Gynecologic Oncology Instituto Nacional de Cancerolog\u00eda  Bogot\u00e1 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