Adenocarcinoma of the uterine cervix: Pathologic features, treatment options, clinical outcome and prognostic variables

Gadducci, Angiolo; Guerrieri, Maria Elena; Cosio, Stefania

doi:10.1016/j.critrevonc.2019.01.006

Cited by 67 publications

(59 citation statements)

References 154 publications

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“…While it is well known that SCC and UCAC present different molecular profiles [32], as well as distinctive pathogenesis and clinical behavior, the current treatment regimens are still relatively the same for both histologically different cervical cancers; these conventionally involve surgery, radiotherapy, and chemotherapy. In line with the above, there is significant evidence that UCAC have a greater propensity to metastasis and have worse prognosis, than SCC [6,33]. Thus, it is feasible to (10x, 20x, 40x, and 63x) from a cervicitis sample.…”

Section: Discussionmentioning

confidence: 67%

“…5 Laboratorio de Inmunobiología, Departamento de Biología Celular y Molecular, CUCBA, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico. 6 Unidad Académica de Ciencias Químico Biológicas y Farmacéuticas, Universidad Autónoma de Nayarit, Tepic, Nayarit, Mexico. 7 Laboratorio de Inmunología, Departamento de Fisiología, CUCS, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico.…”

Section: Acknowledgmentsunclassified

“…Despite the overwhelming prevalence of HPV infections in women, the actual incidence of tumor development in women infected with or without lesions remains very low. There are, clearly, other factors implicated in the progression of the disease, such as immune status and function [4][5][6]. It follows, then, that novel or emerging treatments of cervical cancer could be addressed through the identification of unique markers, such as stress ligands expressed by tumors, which could lead to immune system activation, or rather immune failure via immune escape mechanisms.…”

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confidence: 99%

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Positive staining of the immunoligand B7-H6 in abnormal/transformed keratinocytes consistently accompanies the progression of cervical cancer

et al. 2020

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Background: B7-H6 has been revealed as an endogenous immunoligand expressed in a variety of tumors, but not expressed in healthy tissues. Heretofore, no studies have been reported describing B7-H6 in women with cervical cancer. To investigate this question, our present study was conducted. Results: This retrospective study comprised a total of 62 paraffinized cervical biopsies, which were distributed in five groups: low-grade squamous intraepithelial lesions (LSIL), high-grade squamous intraepithelial lesions (HSIL), squamous cervical carcinoma (SCC), uterine cervical adenocarcinoma (UCAC), and a group of cervicitis (as a control for non-abnormal/non-transformed cells). Cervical sections were stained by immunohistochemistry to explore the expression of B7-H6, which was reported according to the immunoreactive score (IRS) system. We observed a complete lack of B7-H6 in LSIL abnormal epithelial cells. Interestingly, B7-H6 began to be seen in HSIL abnormal epithelial cells; more than half of this group had B7-H6 positive cells, with staining characterized by a cytoplasmic and membranous pattern. B7-H6 in the SCC group was also seen in the majority of the sections, showing the same cytoplasmic and membranous pattern. Strong evidence of B7-H6 was notably found in UCAC tumor columnar cells (in 100% of the specimens, also with cytoplasmic and membranous pattern). Moreover, consistent B7-H6 staining was observed in infiltrating plasma cells in all groups. Conclusions: B7-H6 IRS positively correlated with disease stage in the development of cervical cancer; additionally, B7-H6 scores were found to be even higher in the more aggressive uterine cervical adenocarcinoma, suggesting a possible future therapeutic target for this cancer type.

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Section: Discussionmentioning

confidence: 67%

Section: Acknowledgmentsunclassified

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Positive staining of the immunoligand B7-H6 in abnormal/transformed keratinocytes consistently accompanies the progression of cervical cancer

et al. 2020

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“…In the meantime, in cases diagnosed with cervical adenocarcinoma, the risk of lymph node metastases development is rather related to the presence of stromal invasion and lymph vascular invasion than to the dimensions of the tumor [13,14]. Another important feature of this histopathological subtype is represented by the capacity to develop distant metastases at the level of the ovaries and lymph nodes, when compared to squamous cell carcinoma [16][17][18][19]. However, in our case, the fact that the ovarian tumors proved to have a serous component, while the cervical adenocarcinoma proved to be a mucinous tumor, enabled us to consider that the two malignancies were synchronous and not metastatic lesions.…”

Section: Discussionmentioning

confidence: 99%

Synchronous Cervical Adenocarcinoma and Ovarian Serous Adenocarcinoma—A Case Report and Literature Review

et al. 2020

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Background/Aim: Synchronous gynecological malignancies are rarely encountered, and most often these cases are represented by synchronous ovarian and endometrial cancer. The aim of this paper is to present the case of a 53-year-old patient who was diagnosed with synchronous cervical and ovarian cancer. Case presentation: The patient had been initially investigated for vaginal bleeding and was submitted to a biopsy confirming the presence of a cervical adenocarcinoma. Once the diagnostic of malignancy was confirmed, the patient was submitted to a computed tomography which revealed the presence of large abdominal tumoral nodules of peritoneal carcinomatosis and was submitted to palliative chemotherapy with poor response. Eighteen months later she developed intestinal obstruction and was submitted to surgery. At that moment, synchronous ovarian and cervical tumors were diagnosed. Total radical hysterectomy with bilateral adnexectomy, pelvic and para-aortic lymph node dissection, omentectomy, and pelvic peritonectomy was performed; in the meantime, the histopathological studies confirmed the presence of two synchronous malignancies. Conclusion: Although synchronous lesions are rarely encountered, this eventuality should not be omitted. In such cases, surgery should be taken in consideration and the intent of radicality should regard both lesions.

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“…However, sharing the same treatment regimen, survival data from AC patients remains unsatisfactory [5]. There were increasing evidence showing great differences between AC and SCC of cervix in terms of anatomic origin, risk factors, radiosensitivity, rates of recurrence and survival outcomes [5][6][7][8]. A previous study of our institution reported the 3year overall survival (OS), disease-free survival (DFS), pelvic control and distant control rates of AC and SCC patients with stage IB-IVA disease of International Federation of Gynecology and Obstetrics (FIGO) classification, were 75.4% vs. 85.2% (p = 0.005), 57.3% vs.77.5% (p < 0.001), 74.1% vs. 89.0%…”

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The role of surgery following concurrent chemoradiotherapy in cervical adenocarcinoma

Ma¹,

Wang²,

Hu³

et al. 2020

Preprint

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Purpose: To evaluate the clinical significance of adjuvant hysterectomy in patients with cervical adenocarcinoma (AC) primarily treated by definitive concurrent chemoradiotherapy (CCRT). Methods: We performed a retrospective analysis of cervical AC patients with International Federation of Gynecology and Obstetrics (FIGO) stage IB-IIIB in our hospital between Jan 2005 and Feb 2016. All patients were treated with external radiation(45-50.4Gy in 25 to 28 fractions) and brachytherapy (27-36Gy in 4 to 7 fractions), combined with concurrent chemotherapy including weekly cisplatin (40 mg/m 2 ) or weekly paclitaxel (75 mg/m 2 ). After CCRT, some patients received chemotherapy or hysterectomy, whereas the rest were followed up for observation. Survival outcomes were compared between patients who underwent hysterectomy after radiotherapy with those who did not. Results: A total of 109 cervical AC patients were enrolled. After a median follow-up duration of 48 months(range, 4-135 months), the 3-year overall survival (OS) and progression-free survival (PFS) were 82.3% and 57.8%, respectively. Fifty-two patients underwent hysterectomy after CCRT. The 3-year OS of surgery group was significantly higher than non-surgery group (68.6% vs. 52.8%, p =0.044). 3-year PFS, local progression-free survival (LPFS) and distant metastasis-free survival (DMFS) in surgery and non-surgery group were 59.1% vs. 44.7% ( p = 0.087), 87.6% vs. 66.3% ( p = 0.064) and 71.6% vs. 57.0% ( p =0.24), respectively. In subgroup analysis, hysterectomy significantly improved the 3-year PFS (54.1% vs. 18.8%, p =0.039) and 3-year DMFS (64.2% vs. 20.8%, p =0.030) in patients with residual tumor after CCRT, and had a trend in improving 3-year OS (62.8% vs. 37.5%, p =0.062) and 3-year LPFS (82.8% vs. 49.2%, p =0.082). Grade 3 or more late toxicities of urinary and gastro-intestinal systems in surgery and non-surgery groups were observed in 3.8% vs. 3.5%, and 1.9% vs.3.6% cases, respectively. Conclusion: Hysterectomy improved clinical outcomes of cervical AC patients with residual disease after CCRT. For patients with clinical complete response after CCRT, hysterectomy did not bring further survival benefit. The long-term toxicities of post-radiation surgery was tolerable.

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Adenocarcinoma of the uterine cervix: Pathologic features, treatment options, clinical outcome and prognostic variables

Cited by 67 publications

References 154 publications

Positive staining of the immunoligand B7-H6 in abnormal/transformed keratinocytes consistently accompanies the progression of cervical cancer

Positive staining of the immunoligand B7-H6 in abnormal/transformed keratinocytes consistently accompanies the progression of cervical cancer

Synchronous Cervical Adenocarcinoma and Ovarian Serous Adenocarcinoma—A Case Report and Literature Review

The role of surgery following concurrent chemoradiotherapy in cervical adenocarcinoma

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