J Gynecol Oncol.  2017 Mar;28(2):e19. 10.3802/jgo.2017.28.e19.

Impact of histological subtype on survival in patients with locally advanced cervical cancer that were treated with definitive radiotherapy: adenocarcinoma/adenosquamous carcinoma versus squamous cell carcinoma

• Yokoi E
• Mabuchi S
• Takahashi
• Matsumoto
• Kuroda H
• Kozasa K
• Kimura T

• KMID: 2413458
• DOI: http://doi.org/10.3802/jgo.2017.28.e19

Abstract

OBJECTIVE
To compare the survival outcomes of patients with cervical squamous cell carcinoma (SCC) and adenocarcinoma/adenosquamous carcinoma (AC/ASC) among patients with locally advanced cervical cancer that were treated with definitive radiotherapy.
METHODS
The baseline characteristics and outcome data of patients with locally advanced cervical cancer who were treated with definitive radiotherapy between November 1993 and February 2014 were collected and retrospectively reviewed. A Cox proportional hazards regression model was used to investigate the prognostic significance of AC/ASC histology.
RESULTS
The patients with AC/ASC of the cervix exhibited significantly shorter overall survival (OS) (p=0.004) and progression-free survival (PFS) (p=0.002) than the patients with SCC of the cervix. Multivariate analysis showed that AC/ASC histology was an independent negative prognostic factor for PFS. Among the patients who displayed AC/ASC histology, larger tumor size, older age, and incomplete response to radiotherapy were found to be independent prognostic factors. PFS was inversely associated with the number of poor prognostic factors the patients exhibited (the estimated 1-year PFS rates; 100.0%, 77.8%, 42.8%, 0.0% for 0, 1, 2, 3 factors, respectively).
CONCLUSION
Locally advanced cervical cancer patients with AC/ASC histology experience significantly worse survival outcomes than those with SCC. Further clinical studies are warranted to develop a concurrent chemoradiotherapy (CCRT) protocol that is specifically tailored to locally advanced cervical AC/ASC.

Keyword

Uterine Cervical Neoplasms; Radiotherapy; Adenocarcinoma; Carcinoma, Adenosquamous

MeSH Terms

Adenocarcinoma/*mortality/pathology/radiotherapy
Adult
Aged
Antineoplastic Agents/therapeutic use
Carcinoma, Adenosquamous/*mortality/pathology/radiotherapy
Carcinoma, Squamous Cell/*mortality/pathology/radiotherapy
Chemoradiotherapy
Cisplatin/therapeutic use
Female
Humans
Middle Aged
Multivariate Analysis
Neoplasm Recurrence, Local
Neoplasm Staging
Proportional Hazards Models
Retrospective Studies
Uterine Cervical Neoplasms/*mortality/pathology/radiotherapy
Antineoplastic Agents
Cisplatin