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.

中文翻译：

---

斯坦福参数将恶性潜能不确定的妇科平滑肌肿瘤的复发风险分层

恶性潜能不确定的平滑肌肿瘤（STUMP）是一类肿瘤，定义不明确，代表了诊断难题。我们旨在评估是否可以使用Stanford参数，即有丝分裂指数（≥10/ 10HPF），非典型性明显（中度至重度）和凝血性肿瘤细胞坏死（CTCN），即使在局灶性或模棱两可的情况下也可以使用分级恶性潜能不确定的妇科平滑肌肿瘤的复发风险。从电子数据库创建到2019年10月，都对其进行了搜索。包括了所有评估妇科STUMP系列中斯坦福参数的研究。根据三个Stanford参数的存在将STUMP细分：高有丝分裂指数，显着非典型性和CTCN。进行了Kaplan–Meier生存分析以实现无复发生存。在每个类别中计算危险比（HR）。包括219个STUMP的14个研究。在15.5％的病例中，三个斯坦福参数均不存在，复发风险为5.9％；仅2.7％的病例单独显示高有丝分裂指数，复发风险为0％（HR =无法计算）；仅43.8％的患者表现出明显的非典型性，复发风险为18.7％（HR = 3.3； p = 0.012）；26.5％的病例仅接受CTCN，复发风险为17.2％（HR = 3.1； p = 0.029）；11.4％的病例显示至少两个Stanford参数，复发风险为32％（HR = 7.5； p = 0.003）。斯坦福参数可以将STUMP复发的风险分层。非典型性和CTCN显着，但有丝分裂指数不高，可能是STUMP复发的独立危险因素。至少存在两个斯坦福参数，即使模棱两可（例如 ，不确定或局灶性CTCN，局灶性显着异型性，10 / 10HPF附近的有丝分裂指数）可能仍足以支持平滑肌肉瘤的诊断。在这一领域需要进一步的研究。