Adenocarcinoma histology is a poor prognostic factor in locally advanced cervical cancer

Abstract

Objective: This retrospective study aimed to compare prognostic factors and survival between adenocarcinoma (AC) and squamous cell carcinoma (SCC) in locally advanced cervical cancer treated at a single center.

Methods: All medical records of cervical cancer patients with International Federation of Gynecology and Obstetrics (FIGO) stage IIB or IIIA,B, treated between 2004 and 2012, were reviewed. We treated patients with chemoradiotherapy (CRT) followed by brachytherapy (BT). Multivariate logistic regression and Cox proportional hazard models were used to analyze clinicopathological characteristics, patterns of care and outcomes.

Results: We included in the analysis 161 patients (52 AC; 109 SCC). Patients with AC were younger (age 50 vs. 55 years), more likely to die from the disease (HR: 1.60; 95% CI: 1.26–2.58; p = .001) and to have disease recurrence (HR: 1.69; 95% C.I: 1.21–2.12; p = .004) than those with SCC. The other significant prognostic factors for overall survival (OS) and recurrence-free survival (RFS) in AC were FIGO stage (p = .001; p = .002), WHO status (0 vs. 1–3; p = .003; p = .04), and hemoglobin level (<12 g/dl>; p = .04; p = .02). The 5 year overall survival for stage II of AC and SCC was 63% and 82% (p = .03), and for IIIA,B it was 33.6% and 73% (p = .0005). The 5 year RFS for AC and SCC stage FIGO IIIA,B was 24% and 57% (p = .001).

Conclusions: Adenocarcinoma histology negatively impacts OS and RFS for advanced cervical cancer. Histology-specific therapy may be an opportunity for survival improvement in these women.

Keywords:

• Cervical cancer
• adenocarcinoma
• squamous cell cancer
• histopathology
• chemoradiotherapy
• treatment outcomes

Transparency

Declaration of funding

There was no sponsorship/funding in the preparation of the manuscript.

Author contributions: J.J.G.: project development, data collection, data analysis, manuscript writing; L.G.: data collection, data analysis; A.Z.S.: assistance in manuscript writing, data collection; M.K.: data analysis, manuscript editing; B.K.: assistance in design of the study, manuscript editing. All the authors made the decision to submit the manuscript for publication.

Declaration of financial/other relationships

J.J.G., L.G., A.Z.S., M.K. and B.K. have disclosed that they have no significant relationships with or financial interests in any commercial companies related to this study or article.

CMRO peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgements

None reported.