Comparison of clinical outcomes of adenocarcinoma and adenosquamous carcinoma in uterine cervical cancer patients receiving surgical resection followed by radiotherapy: A multicenter retrospective study (KROG 13-10)

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• 作者：Jae Myoung Noh^a ; Won Park^a ; ^{wonro.park@samsung.com" class="auth_mail} ; Young Seok Kim^b ; Joo-Young Kim^c ; Hak Jae Kim^d ; Juree Kim^e ; Jin Hee Kim^f ; Mee Sun Yoon^g ; Jin Hwa Choi^h ; Won Sup Yoonⁱ ; Ji-Yoon Kim^j ; Seung Jae Huh^a
• 关键词：Cervical cancer ; Adenocarcinoma ; Adenosquamous carcinoma ; Postoperative radiotherapy
• 刊名：Gynecologic Oncology
• 出版年：March, 2014
• 年：2014
• 卷：132
• 期：3
• 页码：618-623
• 全文大小：331 K

文摘

Objective

To evaluate the prognostic influence of adenocarcinoma (AC) and adenosquamous carcinoma (ASC) in patients with FIGO stage IB-IIA cervical cancer who received radical hysterectomy followed by adjuvant radiotherapy (RT) or concurrent chemoradiotherapy (CCRT).

Methods

We analyzed 1323 patients who satisfied the following criteria: histologically proven squamous cell carcinoma (SCC), AC, or ASC of the uterine cervix; FIGO stage IB-IIA disease; no history of neoadjuvant chemotherapy; and a history of radical hysterectomy with pelvic lymph node (PLN) dissection, followed by postoperative pelvic RT at a dose 鈮?#xA0;45 Gy. The median age was 50 years. Median RT dose delivered to the whole pelvis was 50.4 Gy, and 219 (16.6%) patients received brachytherapy at a median dose of 24 Gy. Concurrent chemotherapy was delivered to 492 (37.2%) patients.

Results

Pathologic risk factors were not different according to pathologic subtype. The median follow-up duration was 75.7 months. Locoregional recurrence-free survival, relapse-free survival (RFS), and overall survival were significantly affected by histology, tumor size, PLN metastasis, parametrial invasion, lymphovascular invasion, and deep stromal invasion. The 5-year RFS rates were 83.7%, 66.5%, and 79.6% in patients with SCC, AC, and ASC histology, respectively (P < 0.0001). By multivariate analysis, AC histology was the only significant prognostic factor affecting all survival outcomes.

Conclusions

AC histology was associated with poor survival outcomes in patients with FIGO stage IB-IIA cervical cancer who received adjuvant RT or CCRT. Prognosis of ASC histology was closer to that of SCC histology than that of AC histology.