Spaans VM, et al. - In 82 endocervical adenocarcinoma (AC) patients, researchers sought independent validation for the clinical prognostic significance of a recently proposed classification-system describing three patterns of invasion in usual-type human papillomavirus-associated endocervical AC based on destructiveness of stromal invasion: A – no destructive stromal invasion, B – focal destructive stromal invasion, and C – diffuse destructive stromal invasion. They also explored if there were links between invasion pattern and somatic mutations. Pattern A was seen in 22% cases, pattern B in 37%, and pattern C in 41%. Tumors with pattern A morphology had significantly fewer mutations; pattern A also predicted excellent survival. Overall, the clinical significance of invasion patterns for usual type endocervical AC was independently validated in this study, as recurrence-free and disease-specific survival was independently predicted by tumor size, depth of invasion, lymph-vascular invasion, lymph node metastasis, and invasion pattern in multivariate regression analysis.