A Comparison of Adenosquamous Carcinoma and Adenocarcinoma of the Cervix after Radical Hysterectomy

Lee, Jung‐Yun; Lee, Chulmin; Hahn, Seokyung; Kim, Hee Seung; Chung, Hyun Hoon; Kim, Jae Weon; Park, Noh Hyun; Song, Yong Sang

doi:10.1159/000369387

Cited by 9 publications

(5 citation statements)

References 24 publications

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“…However, the newest analysis by Lee et al [13] showed comparable survival outcome between histology of AS and ASC in patients with stage IB-IIA cervical cancer receiving radical surgery although the ASC group presented more poor pathologic findings. Hong et al [12] also reported their experience of 928 patients with cervical cancer FIGO stage I-IVB who received radiotherapy as the initial treatment, and the patients with AC/ASC had a significantly higher residual disease rate after radiotherapy (40 vs. 21.6%), higher local failure rate (38 vs. 15%) and lower 5-year DFS (50 vs. 66%) compared to patients with SCC [13]. Because the patients in these studies received radiotherapy as a part of their treatment, the underlying radio-responsiveness of AC or ASC may have contributed to the treatment outcomes.…”

Section: Discussionmentioning

confidence: 99%

Pretreatment Factors Associated with Recurrence for Patients with Cervical Cancer International Federation of Gynecology and Obstetrics Stage IB1 Disease

Liu

Huang²,

Hu³

et al. 2015

Gynecol Obstet Invest

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Background: Pretreatment prognostic information is lacking for patients with cervical cancer International Federation of Gynecology and Obstetrics (FIGO) stage IB1 disease. Thus, we attempted to identify a high-risk subgroup among them prior to treatment. Methods: Cervical cancer FIGO stage IB1 patients who had received curative treatment with various modalities in our institute between January 2004 and December 2010 were enrolled. Pretreatment clinical parameters including age, squamous cell carcinoma antigen (SCC-Ag), carcinoembryonic antigen, hemoglobin (Hb) level, platelet count, histological type, and treatment modality were analyzed for treatment outcomes. Results: One hundred ninety-seven patients were included with a median follow-up of 66 months (range 6-119 months). In Cox regression analysis, only SCC histology (HR 0.457, 95% CI 0.241-0.967, p = 0.017) was an independent factor predicting better disease-free survival (DFS). Among SCC histology, patients with an Hb level less than 12 g/dl and a SCC-Ag level more than 3 ng/ml had worse treatment outcomes. The 5-year DFS rates were 89.2, 69.3, and 44.4% for the patients at low-risk (SCC, Hb >12 g/dl, SCC-Ag ≤3 ng/ml), intermediate-risk (non-SCC), and high-risk (SCC, Hb ≤12 g/dl, SCC-Ag >3 ng/ml), respectively (p < 0.001). Conclusion: Non-SCC and SCC histology with both anemia and high pretreatment SCC-Ag level were associated with recurrence. Further validation studies are warranted for clarification.

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Section: Discussionmentioning

confidence: 99%

Pretreatment Factors Associated with Recurrence for Patients with Cervical Cancer International Federation of Gynecology and Obstetrics Stage IB1 Disease

Liu

Huang²,

Hu³

et al. 2015

Gynecol Obstet Invest

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“…In fact, high-risk histologies, such as neuroendocrine and serous tumors of the cervix, have poor prognosis than squamous cell carcinoma and adenocarcinoma [17]. Meanwhile, Lee et al [18] reported that there was no significant difference in survival outcomes between adenocarcinoma and adenosquamous carcinoma in early-stage cervical cancer patient after radical hysterectomy. Some patients with neuroendocrine tumors have distant metastasis, despite radical hysterectomy.…”

Section: Discussionmentioning

confidence: 99%

Is It Possible to Perform Less Radical Surgery for Invasive Uterine Cervical Cancer?

Togami

Kitajima²,

Kobayashi³

et al. 2015

Gynecol Obstet Invest

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Background/Aims: A retrospective analysis was performed to evaluate the possibility of less radical surgery for early-stage invasive uterine cervical cancer without compromising the oncological outcome. Methods: The analysis was performed on 175 patients with invasive uterine cervical cancer in FIGO stage IA2-IIB, all of whom underwent primary radical hysterectomy. Relationship of tumor size with the incidence of pathologic parametrial involvement and the pelvic lymph node metastasis were investigated. Results: Fifty-one patients had tumor size ≤2 cm and 124 had tumor size >2 cm. Patients with tumor size ≤2 cm had a significantly lower incidence of parametrial invasion (p < 0.0001), lymph node metastasis (p < 0.0001), lymph vascular space involvement (p < 0.0001) and recurrence (p = 0.0002) than patients with tumor size >2 cm. Five-year relapse-free survival rate was 98 and 73%, respectively (p = 0.0004). Conclusion: It is suggested that less radical surgery may be appropriate for some cases with tumor size <2 cm.

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“…Peter et al reported that adenocarcinoma and ASC of the cervix are associated with worse OS when treated with radiation alone, but have similar progression free and overall survival compared to squamous cell carcinomas of the cervix when treated with cisplatin-based chemoradiation [ 24 ]. Lee et al concluded that intermediate/high-risk patients with ASC may be successfully treated with postoperative CCRT [ 25 ]. In both studies, ASC was compared to squamous and adenocarcinoma rather than to itself, which may lead to bias.…”

Section: Discussionmentioning

confidence: 99%

The best postoperative adjuvant therapy for patients with early stage cervical adenosquamous carcinoma

Liu

Zhang

et al. 2022

BMC Women's Health

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Background Cervical adenosquamous carcinoma (ASC) was previously thought to be a subtype of cervical adenocarcinoma, but recent studies have found that the clinical features of the two diseases are different. Moreover, the pathological characteristics, survival, prognosis, and optimal ASC therapy remain unknown. This study aims to retrospectively analyze the postoperative survival of patients with early-stage ASC and to evaluate their condition after treatment with postoperative concurrent chemoradiotherapy (CCRT) and prophylactic irradiation of the para-aortic lymphatic drainage area. Methods This study enrolled 131 patients with pathologically confirmed ASC screened from 3502 patients with confirmed stage I–II cervical cancer diagnosis who had completed surgical treatments in our hospital. Among the 131 enrolled patients, 75 patients received CCRT, 33 patients received chemotherapy (CT), and 23 patients did not receive adjuvant treatment (named surgery alone (S alone). Of the 75 patients CCRT, 43 patients received prophylactic irradiation of the para-aortic lymphatic drainage area. The efficacy of the postoperative treatments of patients among groups (CCRT, CT, and S alone) was compared. Results The median follow-up time, age, and overall survival (OS) were 76 months, 43 years, and 74 months, respectively. The 3- and 5-year survival rates were 82% and 71.4%, respectively. The median disease-free survival (DFS) was 64 months. Cox regression analysis showed that postoperative adjuvant treatment modalities and positive lymph node metastases were associated with OS and DFS. Patients who received CCRT treatment had higher OS and DFS than those with CT and S alone. Prophylactic irradiation of the para-aortic lymphatic drainage area did not improve the OS and DFS of patients with CCRT treatment. However, further subgroup analysis suggested that it might improve survival rates in patients who had positive pelvic lymph nodes as confirmed by postoperative pathology. Conclusion Postoperative CCRT improved the survival rates in patients with early-stage ASC. The value of prophylactic irradiation of the para-aortic lymphatic drainage area remains debatable, but it may benefit patients with pelvic lymph node involvement.

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A Comparison of Adenosquamous Carcinoma and Adenocarcinoma of the Cervix after Radical Hysterectomy

Cited by 9 publications

References 24 publications

Pretreatment Factors Associated with Recurrence for Patients with Cervical Cancer International Federation of Gynecology and Obstetrics Stage IB1 Disease

Pretreatment Factors Associated with Recurrence for Patients with Cervical Cancer International Federation of Gynecology and Obstetrics Stage IB1 Disease

Is It Possible to Perform Less Radical Surgery for Invasive Uterine Cervical Cancer?

The best postoperative adjuvant therapy for patients with early stage cervical adenosquamous carcinoma

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