DOI QR코드

DOI QR Code

Prognostic Impact of Histology in Patients with Cervical Squamous Cell Carcinoma, Adenocarcinoma and Small Cell Neuroendocrine Carcinoma

  • Intaraphet, Suthida (Boromarajonnani College of Nursing) ;
  • Kasatpibal, Nongyao (Faculty of Nursing, Chiang Mai University) ;
  • Siriaunkgul, Sumalee (Department of Pathology, Faculty of Medicine, Chiang Mai University) ;
  • Sogaard, Mette (Department of Clinical Epidemiology, The Institute of Clinical Medicine, Aarhus University Hospital) ;
  • Patumanond, Jayanton (Clinical Epidemiology Unit, Faculty of Medicine, Chiang Mai University) ;
  • Khunamornpong, Surapan (Department of Pathology, Faculty of Medicine, Chiang Mai University) ;
  • Chandacham, Anchalee (Department of Gynecology and Obstetrics, Nakornping Hospital) ;
  • Suprasert, Prapaporn (Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University)
  • Published : 2013.09.30

Abstract

Background: Clarifying the prognostic impact of histological type is an essential issue that may influence the treatment and follow-up planning of newly diagnosed cervical cancer cases. This study aimed to evaluate the prognostic impact of histological type on survival and mortality in patients with cervical squamous cell carcinoma (SCC), adenocarcinoma (ADC) and small cell neuroendocrine carcinoma (SNEC). Materials and Methods: All patients with cervical cancer diagnosed and treated at Chiang Mai University Hospital between January 1995 and October 2011 were eligible. We included all patients with SNEC and a random weighted sample of patients with SCC and ADC. We used competing-risks regression analysis to evaluate the association between histological type and cancer-specific survival and mortality. Results: Of all 2,108 patients, 1,632 (77.4%) had SCC, 346 (16.4%) had ADC and 130 (6.2%) had SNEC. Overall, five-year cancer-specific survival was 60.0%, 54.7%, and 48.4% in patients with SCC, ADC and SNEC, respectively. After adjusting for other clinical and pathological factors, patients with SNEC and ADC had higher risk of cancer-related death compared with SCC patients (hazard ratio [HR] 2.6; 95% CI, 1.9-3.5 and HR 1.3; 95% CI, 1.1-1.5, respectively). Patients with SNEC were younger and had higher risk of cancer-related death in both early and advanced stages compared with SCC patients (HR 4.9; 95% CI, 2.7-9.1 and HR 2.5; 95% CI, 1.7-3.5, respectively). Those with advanced-stage ADC had a greater risk of cancer-related death (HR 1.4; 95% CI, 1.2-1.7) compared with those with advanced-stage SCC, while no significant difference was observed in patients with early stage lesions. Conclusion: Histological type is an important prognostic factor among patients with cervical cancer in Thailand. Though patients with SNEC were younger and more often had a diagnosis of early stage compared with ADC and SCC, SNEC was associated with poorest survival. ADC was associated with poorer survival compared with SCC in advanced stages, while no difference was observed at early stages. Further tailored treatment-strategies and follow-up planning among patients with different histological types should be considered.

Keywords

Survival;mortality;cervical cancer;histology;prognostic impact;Thailand

References

  1. Bray F, Carstensen B, Moller H, et al (2005). Incidence trends of adenocarcinoma of the cervix in 13 European countries. Cancer Epidemiol Biomarkers Prev, 14, 2191-9. https://doi.org/10.1158/1055-9965.EPI-05-0231
  2. Chen J, Macdonald OK, Gaffney DK (2008). Incidence, mortality, and prognostic factors of small cell carcinoma of the cervix. Obstet & Gynecol, 111, 1394-402. https://doi.org/10.1097/AOG.0b013e318173570b
  3. Farley JH, Hickey KW, Carlson JW, et al (2003). Adenosquamous histology predicts a poor outcome for patients with advanced-stage, but not early-stage, cervical carcinoma. Cancer, 97, 2196-202. https://doi.org/10.1002/cncr.11371
  4. Ferlay J, Shin HR, Bray F, et al (2008). Estimates of worldwide burden of cancer in 2008: GLOBOCAN, Int J Cancer, 127, 2893-917.
  5. Fregnani JH, Soares FA, Novik PR, Lopes A, Latorre MR (2008). Comparison of biological behavior between early-stage adenocarcinoma and squamous cell carcinoma of the uterine cervix. Eur J Obstet Gynecol Reprod Biol, 136, 215-23. https://doi.org/10.1016/j.ejogrb.2006.10.021
  6. Galic V, Herzog TJ, Lewin SN, et al (2012). Prognostic significance of adenocarcinoma histology in women with cervical cancer. Gynecol Oncol, 125, 287-91. https://doi.org/10.1016/j.ygyno.2012.01.012
  7. Jemal A, Bray F, Center MM, et al (2011). Global cancer statistics. CA Cancer J Clin, 61, 69-90. https://doi.org/10.3322/caac.20107
  8. Kasamatsu T, Onda T, Sawada M, et al (2009). Radical hysterectomy for FIGO stage I-IIB adenocarcinoma of the uterine cervix. Br J Cancer, 100, 1400-5. https://doi.org/10.1038/sj.bjc.6605048
  9. Kosary CL (1994). FIGO stage, histology, histologic grade, age and race as prognostic factors in determining survival for cancers of the female gynecological system: an analysis of 1973-87 SEER cases of cancers of the endometrium, cervix, ovary, vulva, and vagina. Semin Surg Oncol, 10, 31-46. https://doi.org/10.1002/ssu.2980100107
  10. Lee DW, Kim YT, Kim JH, et al (2010). Clinical significance of tumor volume and lymph node involvement assessed by MRI in stage IIB cervical cancer patients treated with concurrent chemoradiation therapy. J Gynecol Oncol, 21, 18-23. https://doi.org/10.3802/jgo.2010.21.1.18
  11. Lee KB, Lee JM, Park CY, Cho HY, Ha SY (2006). What is the difference between squamous cell carcinoma and adenocarcinoma of the cervix? A matched case-control study. Int J Gynecol Cancer, 16, 1569-73. https://doi.org/10.1111/j.1525-1438.2006.00628.x
  12. Liu S, Semenciw R, Mao Y (2001). Cervical cancer: the increasing incidence of adenocarcinoma and adenosquamous carcinoma in younger women. CMA, 164, 1151-2.
  13. Mabuchi S, Okazawa M, Matsuo K, et al (2012). Impact of histological subtype on survival of patients with surgicallytreated stage IA2-IIB cervical cancer: adenocarcinoma versus squamous cell carcinoma. Gynecol Oncol, 127, 114-20. https://doi.org/10.1016/j.ygyno.2012.06.021
  14. Mathew A, George PS (2009). Trends in incidence and mortality rates of squamous cell carcinoma and adenocarcinoma of cervix-worldwide. Asian Pac J Cancer Prev 10, 645-50.
  15. Nakanishi T, Ishikawa H, Suzuki Y, et al (2000). A comparison of prognoses of pathologic stage Ib adenocarcinoma and squamous cell carcinoma of the uterine cervix. Gynecol Oncol, 79, 289-93. https://doi.org/10.1006/gyno.2000.5935
  16. Narukon T, Tuipae S, Siraprapasiri P (2010). Outcomes of treatment for cervical cancer stage IB2 and IIA2; Radical hysterectomy and definitive radiotherapy. Thai J Obstetrics and Gynaecol, 18, 181-90.
  17. Park HJ, Choi YM, Chung CK, et al (2011) at. Pap smear screening for small cell carcinoma of the uterine cervix: a case series and review of the literature. J Gynecol Oncol, 22, 39-43. https://doi.org/10.3802/jgo.2011.22.1.39
  18. Park JY, Kim DY, Kim JH, et al (2010). Outcomes after radical hysterectomy in patients with early-stage adenocarcinoma of uterine cervix. Br J Cancer. 102, 1692-8. https://doi.org/10.1038/sj.bjc.6605705
  19. Rudtanasudjatum K, Charoenkwan K, Khunamornpong S, Siriaunkgul S (2011). Impact of histology on prognosis of patients with early-stage cervical cancer treated with radical surgery. Int J Gynaecol Obstet, 115, 183-7. https://doi.org/10.1016/j.ijgo.2011.06.011
  20. Schorge JO, Schaffer JI, Halvorson LM, Hoffman BL, Bradshaw KD, Cunningham FG, editors. Cervical cancer. In: Williams gynecology. New York: McGraw-Hill, 646-64.
  21. Shingleton HM, Bell MC, Fremgen A, et al (1995). Is there really a difference in survival of women with squamous cell carcinoma, adenocarcinoma, and adenosquamous cell carcinoma of the cervix? Cancer. 76, 1948-55. https://doi.org/10.1002/1097-0142(19951115)76:10+<1948::AID-CNCR2820761311>3.0.CO;2-T
  22. Smith HO, Tiffany MF, Qualls CR, Key CR (2000). The rising incidence of adenocarcinoma relative to squamous cell carcinoma of the uterine cervix in the United States-a 24- year population-based study. Gynecol Oncol, 78, 97-105. https://doi.org/10.1006/gyno.2000.5826
  23. Takeda N, Sakuragi N, Takeda M, et al (2002). Multivariate analysis of histopathologic prognostic factors for invasive cervical cancer treated with radical hysterectomy and systematic retroperitoneal lymphadenectomy. Acta Obstet Gynecol Scand, 81, 1144-51. https://doi.org/10.1034/j.1600-0412.2002.811208.x
  24. Vinh-Hung V, Bourgain C, Vlastos G, et al (2007). Prognostic value of histopathology and trends in cervical cancer: a SEER population study. BMC Cancer, 7, 164. https://doi.org/10.1186/1471-2407-7-164
  25. Wang SS, Sherman ME, Hildesheim A, Lacey JV, Devesa S (2004). Cervical adenocarcinoma and squamous cell carcinoma incidence trends among white women and black women in the United States for 1976-2000. Cancer, 10, 1035-44.
  26. Wright TC, Ferencze A, Kurmam RJ (2002). Carcinoma and other tumors of the cervix. In: Kurmam RJ, Blaustein's pathology of the female genital tract. 5th ed. New York: Springer-Verlag, 207-52.
  27. Zivanovic O, Leitao MM Jr, Park KJ, et al (2009). Small cell neuroendocrine carcinoma of the cervix: Analysis of outcome, recurrence pattern and the impact of platinumbased combination chemotherapy. Gynecol Oncol, 112, 590-3. https://doi.org/10.1016/j.ygyno.2008.11.010

Cited by

  1. Treatment Interruption During Concurrent Chemoradiotherapy of Uterine Cervical Cancer; Analysis of Factors and Outcomes vol.15, pp.14, 2014, https://doi.org/10.7314/APJCP.2014.15.14.5653
  2. Timing of Thoracic Radiotherapy in Limited Stage Small Cell Lung Cancer: Results of Early Versus Late Irradiation from a Single Institution in Turkey vol.15, pp.15, 2014, https://doi.org/10.7314/APJCP.2014.15.15.6263
  3. Lack of any Impact of Histopathology Type on Prognosis in Patients with Early-Stage Adenocarcinoma and Squamous Cell Carcinoma of the Uterine Cervix vol.15, pp.6, 2014, https://doi.org/10.7314/APJCP.2014.15.6.2815
  4. Tumor invasion depth is a useful pathologic assessment for predicting outcomes in cervical squamous cell carcinoma after neoadjuvant radiotherapy vol.10, pp.1, 2015, https://doi.org/10.1186/s13000-015-0426-6
  5. Prognostic Evaluation of Tumor-Stroma Ratio in Patients with Early Stage Cervical Adenocarcinoma Treated by Surgery vol.16, pp.10, 2015, https://doi.org/10.7314/APJCP.2015.16.10.4363
  6. Pretreatment Mean Apparent Diffusion Coefficient Is Significantly Correlated With Event-Free Survival in Patients With International Federation of Gynecology and Obstetrics Stage Ib to IIIb Cervical Cancer vol.25, pp.6, 2015, https://doi.org/10.1097/IGC.0000000000000445
  7. Preoperative D-dimers as an independent prognostic marker in cervical carcinoma vol.36, pp.11, 2015, https://doi.org/10.1007/s13277-015-3650-5
  8. Metastatic Sarcomatoid Squamous Cell Carcinoma of the Cervix Presenting with Chest Mass vol.2017, pp.2090-6714, 2017, https://doi.org/10.1155/2017/5264564
  9. Early-stage node negative cervical adenocarcinoma and squamous cell carcinoma show similar survival outcomes after hysterectomy: a population-based study vol.28, pp.6, 2017, https://doi.org/10.3802/jgo.2017.28.e81
  10. Enhanced efficacy of adjuvant chemotherapy and radiotherapy in selected cases of surgically resected neuroendocrine carcinoma of the uterine cervix vol.96, pp.11, 2017, https://doi.org/10.1097/MD.0000000000006361
  11. Incidence, mortality and determinants of survival from cervical cancer in Northwest Russia: a registry-based cohort study vol.10, pp.2, 2018, https://doi.org/10.1093/inthealth/ihx068
  12. Prognostic value of microvessel density in cervical cancer vol.18, pp.1, 2018, https://doi.org/10.1186/s12935-018-0647-3
  13. Adenocarcinoma histology is a poor prognostic factor in locally advanced cervical cancer pp.1473-4877, 2018, https://doi.org/10.1080/03007995.2018.1502166
  14. The Prognostic Impact of the Number of Metastatic Lymph Nodes and a New Prognostic Scoring System for Recurrence in Early-Stage Cervical Cancer with High Risk Factors: A Multicenter Cohort Study (KROG 15-04) vol.50, pp.3, 2018, https://doi.org/10.4143/crt.2017.346
  15. Neuroendocrine carcinoma of the cervix: a systematic review of the literature vol.18, pp.1, 2018, https://doi.org/10.1186/s12885-018-4447-x
  16. Apparent diffusion coefficients are closely related with high-risk human papilloma virus infection in cervical squamous cell carcinoma patients pp.1600-0455, 2019, https://doi.org/10.1177/0284185119828202