Disparities in Survival Outcomes Between Locally Advanced Cervical Squamous Cell Carcinoma and Adenocarcinoma Treated with Chemoradiotherapy

Figures & data

Table 1 Patient Baseline Characteristics Before and After Propensity Score Matching

Variables	Before PSM				After PSM
	n	SCC (%)	AC (%)	P	n	SCC	AC	P
Age (years)
<50	1184	1071 (44.5)	113 (32.8)	0.001	244	112	112	1
50–64	1088	939 (39.0)	149 (43.3)		292	146	146
≥65	480	398 (16.5)	82 (23.8)		164	82	82
Race
White	2049	1783 (74.0)	266 (77.3)	0.019	528	264	264	1
Black	369	339 (14.1)	30 (8.7)		60	30	30
Other	334	286 (11.9)	48 (14.0)		92	46	46
Grade
Well differentiated	124	85 (3.5)	39 (11.3)	0.001	70	35	35	1
Moderately differentiated	918	835 (34.7)	83 (24.1)		166	83	83
Poorly/undifferentiated	969	852 (35.4)	117 (34.0)		234	117	117
Unknown	741	636 (26.4)	105 (30.5)		210	105	105
FIGO stage
IIB	1051	902 (37.5)	149 (43.3)	0.096	292	146	146	1
III	1607	1421 (59.0)	186 (54.1)		372	186	186
IVA	94	85 (3.5)	9 (2.6)		16	8	8

Abbreviations: PSM, propensity score matching; FIGO, Federation of International of Gynecologists and Obstetricians; SCC, squamous cell carcinoma; AC, adenocarcinoma.

Figure 1 The patient selection flowchart.

Abbreviations: NOS, no other specific; SCC, squamous cell carcinoma; AC, adenocarcinoma.

Figure 2 Comparison of cause-specific survival (A) and overall survival (B) between cervical squamous cell carcinoma (SCC) and adenocarcinoma (AC) before propensity score matching.

Figure 3 Comparison of cause-specific survival (A) and overall survival (B) between cervical squamous cell carcinoma (SCC) and adenocarcinoma (AC) after propensity score matching.

Figure 4 Annual hazard rates for cervical cancer-related death between cervical squamous cell carcinoma (SCC) and adenocarcinoma (AC) (the horizontal axis refers to the year of follow-up; the vertical axis refers to annual hazard rates).

Table 2 Multivariate Prognostic Analysis for Independent Prognostic Factors Associated with Cervical Cancer-Specific Survival and Overall Survival Before Propensity Score Matching

Variables	CCSS			OS
	HR	95% CI	P	HR	95% CI	P
Age (years)
<50	1			1
50–64	0.963	0.836–1.108	0.595	1.183	1.049–1.334	0.006
≥65	1.079	0.900–1.295	0.411	1.633	1.413–1.887	<0.001
Race
White	1			1
Black	1.049	0.868–1.266	0.623	1.055	0.903–1.233	0.500
Other	0.848	0.688–1.045	0.121	0.843	0.710–1.000	0.051
Grade
Well differentiated	1			1
Moderately differentiated	1.111	0.800–1.543	0.531	1.032	0.788–1.352	0.818
Poorly/undifferentiated	1.320	0.955–1.824	0.093	1.242	0.952–1.619	0.11
Unknown	1.053	0.755–1.467	0.761	1.016	0.775–1.333	0.909
FIGO stage
IIB	1			1
III	1.929	1.669–2.230	<0.001	1.807	1.606–2.034	<0.001
IVA	3.317	2.472–4.450	<0.001	2.834	2.192–3.664	<0.001
Histology
SCC	1			1
AC	1.683	1.417–1.999	<0.001	1.486	1.279–1.727	<0.001

Abbreviations: PSM, propensity score matching; FIGO, Federation of International of Gynecologists and Obstetricians; SCC, squamous cell carcinoma; AC, adenocarcinoma; HR, hazard ratio; CI, confidence interval; CCSS, cervical cancer-specific survival; OS, overall survival.

Table 3 Sensitivity Analysis of the Impact of Histology (Adenocarcinoma vs Squamous Cell Carcinoma) on Cervical Cancer-Specific Survival and Overall Survival After Stratification by Age, Race, Tumor Grade, and FIGO Stage

Variables	CCSS			OS
	HR	95% CI	P	HR	95% CI	P
Age (years)
<50	1.377	1.028–1.848	0.032	1.256	0.950–1.660	0.110
50–64	1.622	1.246–2.112	<0.001	1.521	1.219–1.897	<0.001
≥65	2.429	1.692–3.487	<0.001	1.700	1.265–2.286	<0.001
Race
White	1.490	1.227–1.810	<0.001	1.280	1.080–1.517	0.004
Black	3.299	2.010–5.415	<0.001	2.880	1.846–4.492	<0.001
Other	1.997	1.215–3.281	0.006	2.138	1.423–3.212	<0.001
Grade
Well- Moderately differentiated	1.466	1.091–1.969	0.011	1.394	1.086–1.791	0.009
Poorly/undifferentiated	1.725	1.312–2.268	<0.001	1.564	1.232–1.987	<0.001
Unknown	1.869	1.358–2.572	<0.001	1.451	1.093–1.927	0.010
FIGO stage
IIB	2.039	1.517–2.742	<0.001	1.613	1.250–2.080	<0.001
III–IVA	1.717	1.301–2.267	<0.001	1.430	1.188–1.722	<0.001

PSM, propensity score matching; FIGO, Federation of International of Gynecologists and Obstetricians; SCC, squamous cell carcinoma; AC, adenocarcinoma; HR, hazard ratio; CI, confidence interval; CCSS, cervical cancer-specific survival; OS, overall survival.

Table 4 Multivariate Prognostic Analysis for Independent Prognostic Factors Associated with Cervical Cancer-Specific Survival and Overall Survival After Propensity Score Matching

Variables	CCSS			OS
	HR	95% CI	P	HR	95% CI	P
Age (years)
<50	1			1
50–64	1.152	0.866–1.533	0.330	1.380	1.066–1.786	0.015
≥65	1.280	0.921–1.778	0.141	1.790	1.347–2.378	<0.001
Race
White	1			1
Black	1.483	0.978–2.249	0.063	1.560	1.089–2.236	0.015
Other	1.141	0.796–1.635	0.472	1.182	1.865–1.615	0.294
Grade
Well differentiated	1			1
Moderately differentiated	1.163	0.730–1.852	0.525	1.181	0.796–1.752	0.410
Poorly/undifferentiated	1.506	0.973–2.331	0.066	1.462	1.007–2.122	0.046
Unknown	1.092	0.692–1.721	0.706	1.006	0.682–1.485	0.976
FIGO stage
IIB	1			1
III	1.823	1.408–2.360	<0.001	1.807	1.447–2.258	<0.001
IVA	1.815	0.835–3.947	0.133	2.220	1.150–4.286	0.017
Histology
SCC	1			1
AC	1.755	1.370–2.248	<0.001	1.759	1.421–2.178	<0.001

Abbreviations: PSM, propensity score matching; FIGO, Federation of International of Gynecologists and Obstetricians; SCC, squamous cell carcinoma; AC, adenocarcinoma; HR, hazard ratio; CI, confidence interval; CCSS, cervical cancer-specific survival; OS, overall survival.