Adenocarcinoma of the uterine cervix. Prognosis and prognostic significance of histology

Korhonen, Matti

doi:10.1002/1097-0142(19840415)53:8<1760::aid-cncr2820530824>3.0.co;2-4

Cited by 61 publications

(15 citation statements)

References 12 publications

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“…These three reports included several pathological subtypes of adenosquamous cell carcinoma, clear cell carcinoma, or subtypes of which details were not mentioned. As for the prognostic significance of pathological subtype, conflicting results have appeared in the literature (Korhonen, 1984;Alfsen et al, 2001;Lea et al, 2003). In this study, we employed only ordinary subtypes of AC of the uterine cervix to simplify the analysis.…”

Section: Spread Pattern and Failure Sitesmentioning

confidence: 99%

Radical hysterectomy for FIGO stage I–IIB adenocarcinoma of the uterine cervix

et al. 2009

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A retrospective analysis was carried out to identify risk factors for survival and relapse in patients with FIGO stage I -IIB cervical adenocarcinoma (AC), who underwent radical hysterectomy, and to compare outcome and spread pattern with those of squamous cell carcinoma (SCC). One hundred and twenty-three FIGO stage I -IIB patients with AC and 455 patients with SCC, who all underwent primary radical hysterectomy, were reviewed. Among the patients with AC, Cox model identified tumour size (95% CI: 1.35 -30.71) and node metastasis (95% CI: 5.09 -53.44) as independent prognostic factors for survival, and infiltration to vagina (95% CI: 1.15 -5.76) and node metastasis (95% CI: 6.39 -58.87) as independent prognostic factors for relapse. No significant difference was found in survival or relapse between the AC and SCC groups, after adjusting for other clinicopathological characteristics using Cox model. No significant difference was found in the positive rates of lymph nodes or location of initial failure sites between the two groups, but ovarian metastatic rate was significantly higher in patients with pathologic stage IIB AC (P ¼ 0.02). Positive node is a common independent prognostic factor for survival and relapse of patients with AC. FIGO stage I -IIB patients with AC or SCC, who underwent radical hysterectomy, have similar prognosis and spread pattern, but different ovarian metastasis rates. At present, standard treatment options for patients with invasive carcinoma of the uterine cervix are as follows: radical hysterectomy followed by adjuvant radiotherapy or primary radiotherapy with concurrent cisplatin-containing chemotherapy, for the patients with the International Federation of Gynecology and Obstetrics (FIGO) stage IB -IIA disease, with equivalent results; and primary radiotherapy with concurrent chemotherapy for the patients with FIGO stage IIB -IVA disease. These therapeutic strategies have been widely accepted. On the other hand, approximately 85% of the patients with carcinoma of the uterine cervix have squamous lesions, and most of the remaining 10% have adenocarcinoma (AC) lesions (Benedet et al, 2003). To our knowledge, no practice guideline has referred to the treatment option based on the difference of histological types between AC and squamous cell carcinoma (SCC) It is not clear whether these histological types influence outcome or spread pattern, and there is still controversy, as conflicting results have appeared in the literature because of potential limitations of small cohorts of patients with AC. The question whether standard treatment for patients with SCC is also suitable for patients with AC remains unanswered. Additionally, over the last decade, the proportion of AC relative to SCC has doubled, and the rate of AC per population at risk has also increased (Smith et al, 2000). To establish a framework for designing therapeutic strategies, the present retrospective study was undertaken firstly to clarify the clinicopathological features of the surgically treated patients with common typ...

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Section: Spread Pattern and Failure Sitesmentioning

confidence: 99%

Radical hysterectomy for FIGO stage I–IIB adenocarcinoma of the uterine cervix

et al. 2009

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“…Patients with adenocarcinoma show a higher frequency of lymph node metastases at the time of diagnosis than patients with squamous cell carcinoma (32,33). Hypoxia can cause increased expression of several selected genes, including the genes encoding metastasis promoting proteins, and hence enhance the metastatic frequency of tumors (39,40).…”

Section: Discussionmentioning

confidence: 99%

“…The stage-for-stage prognosis has been reported to be better for patients with squamous cell carcinoma than for patients with adenocarcinoma (27 -29), squamous cell carcinomas generally showing a higher response rate to radiation therapy than adenocarcinomas (30,31). The frequency of lymph node metastases at the time of diagnosis is higher for patients with adenocarcinoma than for patients with squamous cell carcinoma (32,33). The biological differences between adenocarcinomas and squamous cell carcinomas that cause the difference in prognosis have not been recognized, but may be related to the tumor microenvironment.…”

Section: Original Articlementioning

confidence: 99%

Oxygen Tension and Vascular Density in Adenocarcinoma and Squamous Cell Carcinoma of the Uterine Cervix

1998

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The prognosis of patients with carcinoma of the uterine cervix has been shown to depend on the oxygenation and vascularization status of the tumors. The purpose of the study reported here was to search for possible differences in oxygen tension and vascular density between adenocarcinomas and squamous cell carcinomas. Ten patients with adenocarcinoma and forty patients with squamous cell carcinoma were included in the study. Oxygen tension was measured polarographically using the Eppendorf pO2 Histograph 6650. Vascular density was determined by histological examination of tumor biopsies. The adenocarcinomas were significantly better oxygenated than the squamous cell carcinomas. The squamous cell carcinomas and the adenocarcinomas did not differ significantly in vascular density. The difference in prognosis between patients with adenocarcinoma and patients with squamous cell carcinoma is probably not attributable to differences in tumor oxygenation or vascularization.

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“…Korhonen suggested, after the analysis of 163 cases of primary cervical adenocarcinomas of different subtypes, that the prognosis of clear cell carcinomas is similar to that of non-clear cell cervical adenocarcinomas [17]. Reich et al did not find a statistically significant difference in the prognosis of surgically treated patients with stage IB-IIB clear cell carcinomas, squamous cell carcinomas and non-clear cell adenocarcinomas [18].…”

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confidence: 99%

“…The question whether cervical clear cell adenocarcinoma and adenocarcinoma have worse prognosis than squamous cell carcinoma of the uterine cervix remains open [4,17,18]. Korhonen suggested, after the analysis of 163 cases of primary cervical adenocarcinomas of different subtypes, that the prognosis of clear cell carcinomas is similar to that of non-clear cell cervical adenocarcinomas [17].…”

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confidence: 99%

Letter to the Editor Clear cell adenocarcinoma of the uterine cervix in a 24-year-old woman. and review of the literature

Gottwald¹,

Korczyński²,

Góra³

et al. 2012

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Carcinoma of the uterine cervix is the most common gynecologic malignant neoplasm all over the world [1,2], but the second one in Poland after carcinoma of the endometrium [3]. In 2009 in Poland the number of its new cases was 3102, and the age-adjusted incidence rate was 10.2 per 100 000 women. In the age group 20-24 year the age-adjusted incidence rate of the cervical cancer was 0.4 per 100 000, and there were 6 new cases noted in Poland. It constituted 1.86% of the cancer incidence rate of all localizations in this age group in Poland [3]. The most common histological type of malignant cervical neoplasms is squamous cell carcinoma. Adenocarcinomas account only for approximately 15% of malignant cervical tumors [1,2,4,5]. The screening based on exfoliative cytology introduced in the 1950s by Papanicolau, followed by colposcopy in appropriate patients, is an effective method for identifying squamous intraepithelial lesions [1,2].The goals of colposcopy are to identify suspicious areas that require biopsy and to determine the extent of the lesions [2]. Treatment of intraepithelial lesions is determined on the basis of the histological diagnosis and the extent of the lesions on colposcopic examination [1,2].Unfortunately, the Pap-smear screening is less efficient, or even of no benefit in cervical adenocarcinomas [4][5][6]. The marked decrease of the incidence of cervical squamous cell carcinoma in the last decades thanks to the screening appears to be in contrast to the increasing rate of cervical adenocarcinomas [4,5]. The diagnosis, when cervical cancer does not arise from the squamous epithelium, and additionally the patient is a young woman, can be very difficult.A 24-year-old woman, without any coexisting diseases, with negative familial cancer history, was admitted to our department in February 2005 because of primary clear cell adenocarcinoma of the uterine cervix. She had reported abnormal vaginal bleeding, non-specific symptoms such as head-ache and nausea, and weight loss (nearly 12 pounds), which had been appearing for the last 6 months. For that time she had been taking

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Adenocarcinoma of the uterine cervix. Prognosis and prognostic significance of histology

Cited by 61 publications

References 12 publications

Radical hysterectomy for FIGO stage I–IIB adenocarcinoma of the uterine cervix

Radical hysterectomy for FIGO stage I–IIB adenocarcinoma of the uterine cervix

Oxygen Tension and Vascular Density in Adenocarcinoma and Squamous Cell Carcinoma of the Uterine Cervix

Letter to the Editor Clear cell adenocarcinoma of the uterine cervix in a 24-year-old woman. and review of the literature

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