ArticleThe American journal of surgical pathology2017
The Microcystic, Elongated, and Fragmented (MELF) Pattern of Invasion: A Single Institution Report of 464 Consecutive FIGO Grade 1 Endometrial Endometrioid Adenocarcinomas.
Article in The American journal of surgical pathology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 56 citations in OpenAlex.
- Pooled it
- Microcystic, elongated, and fragmented (MELF) pattern of myometrial invasion in grade 1-2 endometrioid endometrial carcinoma: clinicopathological associations, molecular profile, and prognostic significance under FIGO 2023 staging.Frontiers in oncology · 2026Article
- Assessment of endometrial cancer with microcystic, elongated, and fragmented pattern invasion using multiparametric MRI.Abdominal radiology (New York) · 2025Article
- Molecular classification and adjuvant treatment in endometrioid endometrial cancer with microcystic elongated and fragmented (MELF) invasion pattern.BMC women's health · 2024Article
- Article
- Article
- Can the microcystic, elongated and fragmented pattern of invasion influence the evaluation of the depth of myometrial invasion in low-grade endometrioid endometrial cancer using imaging techniques?Ultrasound (Leeds, England) · 2023Article
- Robotic omentectomy in gynecologic oncology: surgical anatomy, indications, and a technical approach.Journal of robotic surgery · 2023Review
- Single-cell profiling of low-stage endometrial cancers identifies low epithelial vimentin expression as a marker of recurrent disease.EBioMedicine · 2023Article
- Development of a novel predictive model for lymph node metastasis in patients with endometrial endometrioid carcinoma.BMC cancer · 2022Article
- Is microcystic, elongated, and fragmented pattern of myometrial invasion in endometrioid endometrial carcinoma associated with survival?Turkish journal of medical sciences · 2022Article
- Prognositc Significance of Microcystic Elongated and Fragmanted (MELF) Myometrial Invasion Pattern: A Retrospective StudyMedeniyet medical journal · 2022Article
- Patterns of Myometrial Invasion in Endometrial Adenocarcinoma with Emphasizing on Microcystic, Elongated and Fragmented (MELF) Glands Pattern: A Narrative Review of the Literature.Diagnostics (Basel, Switzerland) · 2021Review
- [Current WHO classification of the female genitals : Many new things, but also some old].Der Pathologe · 2021Review
- Microcystic, Elongated and Fragmented Pattern Invasion Can Adversely Influence Preoperative Staging for Low-grade Endometrial Carcinoma.Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine · 2021Article
- Understanding the role of indoleamine-2,3-dioxygenase and stromal differentiation in rare subtype endometrial cancer.Rare tumors · 2021Article
- Clinicopathologic Association and Prognostic Value of MELF Pattern in Invasive Endocervical Adenocarcinoma (ECA) as Classified by IECC.International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists · 2020Article
- Malignant peritoneal cytology and decreased survival of women with stage I endometrioid endometrial cancer.European journal of cancer (Oxford, England : 1990) · 2020Observational
- Myoinvasive Pattern as a Prognostic Marker in Low-Grade, Early-Stage Endometrioid Endometrial Carcinoma.Cancers · 2019Article
- High Expression of Galectin-1, VEGF and Increased Microvessel Density Are Associated with MELF Pattern in Stage I-III Endometrioid Endometrial Adenocarcinoma.Journal of pathology and translational medicine · 2019Article
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
MELF invasion has been associated with nonvaginal recurrences and lymph node (LN) metastases in multi-institutional case control studies but has not been well examined in large single-institution cohorts. Hysterectomy specimens with FIGO 1 endometrioid endometrial carcinoma and lymphadenectomies from 2007 to 2012 were identified. Electronic medical records and histologic slides were reviewed. Of 464 identified cases, 163 (35.1%) were noninvasive, 60 (12.9%) had MELF, 222 (47.8%) had a component of the infiltrative invasion pattern without MELF, 13 (2.8%) had pure pushing borders of invasion, 5 (1.1%) had pure adenomyosis-like invasion, and 1 (0.2%) had pure adenoma malignum-like invasion. Sixteen cases had LN metastases. Significantly more MELF cases had positive LNs than non-MELF cases overall (18.3% vs. 1.2%, P<0.001). The results were almost identical when invasive infiltrative cases with and without MELF were compared (18.3% vs. 1.8%, P<0.001). The maximum number of MELF glands per slide did not differ between cases with and without LN metastases, P=0.137. A majority of positive LNs, even in MELF cases, demonstrated nonhistiocyte-like metastases. Only 5 cases (all with MELF invasion) demonstrated micrometastatic lesions or isolated tumor cells only. MELF cases demonstrated a nonsignificant decrease in time to extravaginal recurrence (P=0.082, log-rank test), for which analysis was limited by low recurrence rates. In summary, MELF is associated with LN metastases, even when compared with other infiltrative cases and shows multiple patterns of growth in positive LNs. MELF cases additionally trended toward decreased time to extravaginal recurrence.
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Registered trials
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