J Gynecol Oncol.  2017 Nov;28(6):e81. 10.3802/jgo.2017.28.e81.

Early-stage node negative cervical adenocarcinoma and squamous cell carcinoma show similar survival outcomes after hysterectomy: a population-based study

• Wu SG
• Sun JY
• He ZY
• Chen QH
• Zhou J

• KMID: 2413207
• DOI: http://doi.org/10.3802/jgo.2017.28.e81

Abstract

OBJECTIVE
To investigate the clinicopathological features and outcomes between node-negative, early-stage cervical squamous cell carcinoma (SCC) and adenocarcinoma (AC) after hysterectomy.
METHODS
Patients diagnosed with International Federation of Gynecology and Obstetrics (FIGO) stages I-IIA cervical SCC and AC between 1988 and 2013 were retrospectively reviewed using the Surveillance, Epidemiology, and End Results database. We used propensity score-matching to balance patient baseline characteristics. Univariate and multivariate Cox regression analyses were used for prognostic analyses of cause-specific survival (CSS) and overall survival (OS).
RESULTS
A total of 9,858 patients were identified, comprising 6,117 patients (62.1%) and 3,741 (37.9%) patients with cervical SCC and AC, respectively. Compared with cervical SCC, cervical AC cases were more likely to be younger, diagnosed after 2000, white, and have well-differentiated and FIGO stage IB1 disease. For SCC and AC, the 10-year CSS rates were 93.4% and 94.7%, respectively (p=0.011), and the 10-year OS rates were 89.6% and 92.2%, respectively (p<0.001). Multivariate analysis revealed that age, ethnicity, tumor grade, and FIGO stage were independent prognostic factors of CSS and OS, but that histologic subtype was not associated with CSS and OS. In the propensity score-matched patient population, univariate and multivariate analyses also showed that histologic subtype was not associated with survival outcomes.
CONCLUSION
Cervical AC has equivalent survival to cervical SCC in node-negative, early-stage disease after hysterectomy and lymphadenectomy.

Keyword

Uterine Cervical Neoplasms; General Surgery; Prognosis

MeSH Terms

Adenocarcinoma/pathology/*surgery
Adult
Aged
Carcinoma, Squamous Cell/pathology/*surgery
Female
Humans
*Hysterectomy
*Lymph Node Excision
Lymph Nodes/pathology
Middle Aged
Multivariate Analysis
Neoplasm Staging
Prognosis
Propensity Score
Proportional Hazards Models
Retrospective Studies
SEER Program
Survival Rate
Uterine Cervical Neoplasms/pathology/*surgery