DOI QR코드

DOI QR Code

Does Microinvasive Adenocarcinoma of Cervix Have Poorer Treatment Outcomes than Microinvasive Squamous Cell Carcinoma?

  • Ruengkhachorn, Irene (Gynecologic Oncology Division, Department of Obstetrics & Gynecology, Mahidol University) ;
  • Hanamornroongruang, Suchanan (Department of Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University) ;
  • Leelaphatanadit, Chairat (Gynecologic Oncology Division, Department of Obstetrics & Gynecology, Mahidol University) ;
  • Sangkarat, Suthi (Gynecologic Oncology Division, Department of Obstetrics & Gynecology, Mahidol University)
  • Published : 2016.08.01

Abstract

Background: To compare the pathological findings and oncologic outcomes of stage IA cervical carcinoma patients, between adenocarcinoma and squamous cell carcinoma cases. Materials and Methods: A total of 151 medical records of stage IA cervical carcinoma patients undergoing primary surgical treatment during 2006-2013 were reviewed. Information from pathological diagnosis and recurrence rates were compared with descriptive statistical analysis. The Kaplan-Meier method and Cox proportional hazards model were used for survival analysis. Results: The median age was 48.9 years. There was no significant difference in rates of lymph node, parametrium, uterine, vaginal, or ovarian metastasis, when comparing adenocarcinoma with squamous cell carcinoma. Overall recurrence rates of adenocarcinoma (5.7%) and squamous cell carcinoma (2.6%) were not statistically significant different, even when stratified by stage. When comparing progression free survival with squamous cell carcinoma, adenocarcinoma had an HR of 0.448 (0.073-2.746), p=0.386. Conclusions: Microinvasive adenocarcinoma of cervix has similar rate of extracervical involvement and oncologic outcomes to squamous cell carcinoma.

Keywords

Cancer;cervix;histopathology;adenocarcinoma;microinvasion

References

  1. Attasara P, Sriplung H (2013). Cancer incidence in Thailand. In: Khuhaprema T, Attasara P, Sriplung H, Wiangnon S, Sangrajrang S, eds. Cancer in Thailand Vol. VII. Bangkok: Lyon: International Agency for research on Cancer, 8-76.
  2. Bisseling KC, Bekkers RL, Rome RM, et al (2007). Treatment of microinvasive adenocarcinoma of the uterine cervix: a retrospective study and review of the literature. Gynecol Oncol, 107, 424-30. https://doi.org/10.1016/j.ygyno.2007.07.062
  3. Covens A, Kirby J, Shaw P, et al (1999). Prognostic factors for relapse and pelvic lymph node metastases in early stage I adenocarcinoma of the cervix. Gynecol Oncol, 74, 423-7. https://doi.org/10.1006/gyno.1999.5466
  4. Denny L, Quinn M (2015). FIGO Cancer Report 2015. Int J Gynaecol Obstet, 131, 75. https://doi.org/10.1016/j.ijgo.2015.06.024
  5. Fujiwara H, Yokota H, Monk B, et al (2014). Gynecologic Cancer InterGroup (GCIG) consensus review for cervical adenocarcinoma. Int J Gynecol Cancer, 24, 96-101. https://doi.org/10.1097/IGC.0000000000000263
  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. Gien LT, Beauchemin MC, Thomas G (2010). Adenocarcinoma: a unique cervical cancer. Gynecol Oncol, 116, 140-6. https://doi.org/10.1016/j.ygyno.2009.09.040
  8. Hou J, Goldberg GL, Qualls CR, et al (2011). Risk factors for poor prognosis in microinvasive adenocarcinoma of the uterine cervix (IA1 and IA2): a pooled analysis. Gynecol Oncol, 121, 135-42. https://doi.org/10.1016/j.ygyno.2010.11.036
  9. Kasamatsu T, Okada S, Tsuda H, et al (2002). Early invasive adenocarcinoma of the uterine cerix: criteria for nonradical surgical treatment. Gynecol Oncol, 85, 327-32. https://doi.org/10.1006/gyno.2002.6624
  10. Landoni F, Maneo A, Cormio G, et al (2001). Class II versus class III radical hysterectomy in stage IB-IIA cervical cancer: a prospective randomized study. Gynecol Oncol, 80, 3-12. https://doi.org/10.1006/gyno.2000.6010
  11. Magrina JF, Goodrich MA, Weaver AL, et al (1995). Modified radical hysterectomy: morbidity and mortality. Gynecol Oncol, 59, 277-82. https://doi.org/10.1006/gyno.1995.0022
  12. Monk BJ, Tian C, Rose PG, et al (2007). Which clinical/ pathologic factors matter in the era of chemoradiation as treatment for locally advanced cervical carcinoma? Analysis of two Gynecologic Oncology Group (GOG) trials. Gynecol Oncol, 105, 427-33. https://doi.org/10.1016/j.ygyno.2006.12.027
  13. Ostor A, Rome R, Quinn M (1997). Microinvasive adenocarcinoma of the cervix: a clinicopathologic study of 77 women. Obstet Gynecol, 89, 88-93. https://doi.org/10.1016/S0029-7844(96)00386-9
  14. 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
  15. Pecorelli S, Zigliani L, Odicino F (2009). Revised FIGO staging for carcinoma of the cervix. Int J Gynaecol Obstet, 105, 107-8. https://doi.org/10.1016/j.ijgo.2009.02.009
  16. Poynor EA, Marshall D, Sonoda Y, et al (2006). Clinicopathologic features of early adenocarcinoma of the cervix initially managed with cervical conization. Gynecol Oncol, 103, 960-5. https://doi.org/10.1016/j.ygyno.2006.05.041
  17. Reade CJ, Eiriksson LR, Covens A (2013). Surgery for early stage cervical cancer: how radical should it be? Gynecol Oncol, 131, 222-30. https://doi.org/10.1016/j.ygyno.2013.07.078
  18. Reynolds EA, Tierney K, Keeney GL, et al (2010). Analysis of outcomes of microinvasive adenocarcinoma of the uterine cervix by treatment type. Obstet Gynecol, 116, 1150-7. https://doi.org/10.1097/AOG.0b013e3181f74062
  19. Shimada M, Nishimura R, Nogawa T, et al (2013). Comparison of the outcome between cervical adenocarcinoma and squamous cell carcinoma patients with adjuvant radiotherapy following radical surgery: SGSG/TGCU Intergroup Surveillance. Mol Clin Oncol, 1, 780-4. https://doi.org/10.3892/mco.2013.112
  20. Shepherd JH (2012). Cervical cancer. Best Pract Res Clin Obstet Gynaecol, 26, 293-309. https://doi.org/10.1016/j.bpobgyn.2011.12.004
  21. Spoozak L, Lewin SN, Burke WM, et al (2012). Microinvasive adenocarcinoma of the cervix. Am J Obstet Gynecol, 206, 801-6. https://doi.org/10.1016/j.ajog.2011.07.029
  22. Winer I, Alvarado-Cabrero I, Hassan O, et al (2015). The prognostic significance of histologic type in early stage cervical cancer - A multi-institutional study. Gynecol Oncol, 137, 474-8. https://doi.org/10.1016/j.ygyno.2015.02.005
  23. World Health Organization, International Agency for Research on Cancer (IARC). GLOBOCAN 2012: Estimated Cancer Incidence, Mortality and Prevalence Wordwide in 2012. http://globocan.iarc.fr/Pages/fact_sheets_cancer.aspx. Accessed April 15, 2016.
  24. Yoneda JY, Braganca JF, Sarian LO, et al (2015). Surgical treatment of microinvasive cervical cancer: analysis of pathologic features with implications on radicality. Int J Gynecol Cancer, 25, 694-8. https://doi.org/10.1097/IGC.0000000000000416