A comparison of the prognosis between adenocarcinoma and squamous cell carcinoma in stage IB–IIA cervical cancer

Xie, Xiaoyan; Song, Kun; Cui, Baoxia; Jiang, Jie; Yang, Xinggang; Kong, Beihua

doi:10.1007/s10147-017-1225-8

Cited by 36 publications

(41 citation statements)

References 33 publications

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“…Controversy persists regarding differences in survival outcomes between ADC and SCC in patients with cervical cancer [ 6 8 9 10 11 12 ]. In the present study, we performed a PSM analysis to compare survival outcomes between patients with cervical ADC and SCC from the SEER database.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, the International Federation of Gynecology and Obstetrics (FIGO) staging system is the most accurate classification used to predict the prognosis and guide the treatment of cervical cancer. However, no difference in treatment strategies has been identified between SCC and ADC [ 8 ]. Many studies have attempted to determine whether these different histological subtypes have any effect on survival.…”

Section: Introductionmentioning

confidence: 99%

“…Many studies have attempted to determine whether these different histological subtypes have any effect on survival. However, previous studies produced inconsistent results [ 6 8 9 10 11 12 ]. Inconsistencies are not only due to small sample sizes but also to lack of randomized controlled trials.…”

Section: Introductionmentioning

confidence: 99%

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Does adenocarcinoma have a worse prognosis than squamous cell carcinoma in patients with cervical cancer? A real-world study with a propensity score matching analysis

et al. 2020

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Objective To compare survival outcomes between cervical adenocarcinoma (ADC) and squamous cell carcinoma (SCC) using a propensity score matching (PSM) analysis based on the Surveillance, Epidemiology, and End Results (SEER) Program. Methods Patients diagnosed with cervical cancer between 1998 and 2016 were identified from the SEER database. The Kaplan-Meier method and Cox regression analysis were used to analyze survival. A subgroup analysis of overall survival (OS) between patients with ADC and SCC was performed after the 1:1 PSM analysis. Results Of the 33,148 patients, 24,591 (79.19%) had SCC and 8,557 (25.81%) had ADC. In the unmatched cohort, after adjustment in multivariate analysis, patients with ADC had a worse prognosis than patients with SCC (hazard ratio [HR]=1.12; 95% confidence interval [CI]=1.07–1.18; p<0.001). In the propensity matched cohort, Kaplan-Meier analysis and subgroup analysis showed that ADC was associated with a worse prognosis than SCC (p=0.001). An analysis stratified by SEER stage revealed a worse prognosis for patients with ADC patients presenting with a regional disease than patients with SCC (HR=1.24; 95% CI=1.14–1.36 p<0.001), but no statistically significant differences were observed between the localized disease (HR=0.97; 95% CI=0.86–1.10; p=0.664) and distant disease (HR=1.09; 95% CI=0.97–1.22; p=0.162) subgroups. Conclusion The significant differences in survival outcomes between patients with cervical ADC and SCC were only observed in the regional disease subgroup, but not in the localized disease and distant disease subgroups.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Does adenocarcinoma have a worse prognosis than squamous cell carcinoma in patients with cervical cancer? A real-world study with a propensity score matching analysis

et al. 2020

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“…The incidence of ovarian metastases was 0% in stage IA, 2.8% in stage IB, 3.4% in stage IIA, and 11.8% in stage IIB cervical adenocarcinoma. Five studies (7, 9, 12, 22, 26) showed that FIGO stage, tumor size, DSI, LNM, and vaginal invasion are significantly related to poor prognosis. Nine studies (7, 14, 16, 17, 29–34) reported that age, FIGO stage, tumor size, DSI, parametrial invasion (PMI), corpus uteri invasion (CUI), LNM, vaginal invasion, and blood vessel invasion are significantly associated with ovarian metastases.…”

Section: Resultsmentioning

confidence: 99%

Oncological Outcomes and Safety of Ovarian Preservation for Early Stage Adenocarcinoma of Cervix: A Systematic Review and Meta-Analysis

et al. 2019

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Objectives: To evaluate the oncological outcomes and safety of ovarian preservation, and to review the prognostic factors for ovarian metastases in early stage cervical adenocarcinoma. Methods: PubMed, Embase, and Cochrane databases were searched for publications up to January 2019. Two investigators independently screened the studies for eligibility and extracted specific data. The primary outcomes were overall survival (OS) and progression-free survival (PFS). Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using STATA statistical software version 19.0. Results: A total of 68 unique manuscripts were identified through the search strategy, and 10 studies were included in the meta-analysis of the safety of ovarian preservation. Fixed-effects model was used because of moderate heterogeneity. Pooled results of the included studies showed that ovarian preservation is not associated with a statistically significant OS (OR 1.00, 95% CI 0.64–1.56, I 2 = 25.7%) or PFS (OR 0.98, 95% CI 0.57–1.66, I 2 = 0%) in early stage cervical adenocarcinoma. In addition, 19 studies were included in the review of prognostic factors for cervical adenocarcinoma and risk factors for ovarian metastases. The incidence of ovarian metastases was 0% in stage IA, 2.8% in stage IB, 3.4% in stage IIA, and 11.8% in stage IIB cervical adenocarcinoma. International Federation of Gynecology and Obstetrics (FIGO) stage, tumor size, deep stromal invasion (DSI), lymph node metastasis (LNM), and vaginal invasion were significantly related to poor prognosis. Risk factors associated with ovarian metastases included age, FIGO stage, tumor size, DSI, parametrial invasion, corpus uteri invasion, LNM, vaginal invasion, and blood vessel invasion. Conclusions: Ovarian preservation in young patients with early stage cervical adenocarcinoma is safe and has no significant effect on OS or PFS. Preserving ovaries in patients with FIGO stage IIB seems not reasonable because of the high rate of ovarian metastasis.

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“…Currently, the studies on the relationship of keratinized cervical squamous cell carcinoma and patient prognosis has been controversial. It’s been reported [ 37 – 39 ] that compared with non-keratinized cervical squamous cell carcinoma, the survival rate of keratinized cervical squamous cell carcinoma is significantly reduced, and it is not sensitive to radiotherapy, and the prognosis is very poor for untreated patients or advanced patients. Therefore, differentiate the various subtypes of squamous cell carcinoma of cervix is very helpful in clinical management.…”

Section: Discussionmentioning

confidence: 99%

The Adler grade by Doppler ultrasound is associated with clinical pathology of cervical cancer: Implication for clinical management

Che

Yang²,

Wei

et al. 2020

PLoS ONE

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Objective To analyze the relationship of Adler grade by transvaginal color Doppler flow imaging (TV-CDFI) and the clinical pathological parameters of patients with cervical cancer, and to identify the value of Adler grade in the diagnosis and treatment of cervical cancer. Methods Patients with cervical cancer diagnosed pathologically in our hospital from January 1, 2019 to December 31, 2019 were included, All patients underwent TV-CDFI examination, and the images were divided into 0 to III grades according to the Adler grades, and the correlations between the Adler classification and clinical pathological parameters (clinical stage, mass size, pathological type, squamous cell carcinoma subtype, CA125, CA199) were analyzed. Results A total of 162 patients with cervical cancer were included. With the increase of Adler severity, the clinical stage of cervical cancer increased accordingly. the cancer size differed significantly in patients with different Adler grade (p = 0.004); There were significant differences in the level of CA125, CA199 between the squamous cell carcinoma and adenocarcinoma (all p<0.05). the Adler grade was positively related with the clinical stage, pathological type and squamous cell carcinoma subtypes of cervical cancer (all p<0.05), no correlations were found among the Adler grade and the cancer size, CA125, CA199 (all p>0.05). The area under ROC curve of the cervical squamous cell carcinoma predicted by Adler grade based on FIGO results and pathological results was 0.811and 0.762 respectively (all p<0.05). Conclusions Adler grades are closely associated with the clinical pathology of cervical cancer, which may be a convenient and effective approach for the assisting assessment of cervical cancer.

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A comparison of the prognosis between adenocarcinoma and squamous cell carcinoma in stage IB–IIA cervical cancer

Abstract: In stage IB-IIA CC, there is no difference in prognosis between AC and SCC. The ovaries of stage IB-IIA1 AC patients under age 45 might be preserved.

Cited by 36 publications

References 33 publications

Does adenocarcinoma have a worse prognosis than squamous cell carcinoma in patients with cervical cancer? A real-world study with a propensity score matching analysis

Does adenocarcinoma have a worse prognosis than squamous cell carcinoma in patients with cervical cancer? A real-world study with a propensity score matching analysis

Oncological Outcomes and Safety of Ovarian Preservation for Early Stage Adenocarcinoma of Cervix: A Systematic Review and Meta-Analysis

The Adler grade by Doppler ultrasound is associated with clinical pathology of cervical cancer: Implication for clinical management

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