Comparison of biological behavior between early-stage adenocarcinoma and squamous cell carcinoma of the uterine cervix

Fregnani, José Humberto Tavares Guerreiro; Soares, Fernando Augusto; Novik, P. R.; Lopes, Ademar; Latorre, Maria R. D. O.

doi:10.1016/j.ejogrb.2006.10.021

Cited by 27 publications

(29 citation statements)

References 25 publications

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“…Hence, because the survival of surgically treated patients with early-stage cervical cancer is excellent, the magnitude of differences in RFS and OS among different histologic types is small. Previous studies have reported that the magnitude of differences in 5-year RFS and OS rates ranged from 2.0 to 9.0%, findings similar to ours (Look et al, 1996;Lai et al, 1999;Nakanishi et al, 2000;Ayhan et al, 2004;Fregnani et al, 2008). As far as we know, our series is one of the largest studies which compared the survival outcomes of early-stage AdCa and SCCa.…”

Section: Discussionsupporting

confidence: 70%

“…The prognosis of patients with AdCa after RH is unclear, primarily because studies have been performed on small numbers of patients. Some of these studies found that patients with AdCa have poorer prognosis than do those with SCCa (Hopkins and Morley, 1991;Eifel et al, 1995;Look et al, 1996;Samlal et al, 1997;Lai et al, 1999;Kim et al, 2000;Nakanishi et al, 2000), whereas other reports found no differences in prognosis (AntonCulver et al, 1992;Miller et al, 1993;Shingleton et al, 1995;Grisaru et al, 2001;Ayhan et al, 2004;Lee et al, 2006;Fregnani et al, 2008;Kasamatsu et al, 2009). Therefore, the prognosis after RH and the optimal management of AdCa are still a subject of debate.…”

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confidence: 88%

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Outcomes after radical hysterectomy in patients with early-stage adenocarcinoma of uterine cervix

Kim

et al. 2010

Br J Cancer

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BACKGROUND: To determine the prognostic factors and treatment outcomes of patients with early-stage adenocarcinoma (AdCa) of uterine cervix who underwent radical hysterectomy (RH). METHODS: Patients with early-stage squamous cell carcinoma (SCCa) of the uterine cervix who underwent RH were compared with patients with AdCa by multivariate analysis. RESULTS: A total of 1218 patients were eligible, of which 996 (81.8%) had SCCa and 222 (18.2%) had AdCa. In multivariate analysis, parametrial involvement and lymph node metastasis were significant factors for both recurrence-free survival(RFS) and overall survival (OS) of patients with AdCa, whereas age, tumour size, parametrial involvement and lymph node metastasis were significant factors for both RFS and OS of patients with SCCa. After adjusting for significant prognostic factors, patients with AdCa had significantly poorer RFS (odds ratio (OR) ¼ 2.07, 95% confidence interval (CI) ¼ 1.37 -3.12, P ¼ 0.001) and OS (OR ¼ 2.56, 95% CI ¼ 1.65 -3.96, Po0.001) than patients with SCCa. Recurrence outside the pelvis was more frequent in AdCa than in those with SCCa (75 vs 57.8%, P ¼ 0.084). CONCLUSION(S): Although RH is still acceptable for treatment of patients with AdCa, a more effective systemic adjuvant therapy is required.

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Section: Discussionsupporting

confidence: 70%

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confidence: 88%

Outcomes after radical hysterectomy in patients with early-stage adenocarcinoma of uterine cervix

Kim

et al. 2010

Br J Cancer

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“…In agreement with these finding, other studies have reported poorer survival only among early-stage patients with ADC who have lymph node metastasis compared with those with SCC (Nakanishi et al, 2000;Takeda et al, 2002;Rudtanasudjatum et al, 2011) while another study demonstrated a poorer survival of early-stage patients with ADC even though the clinical and pathological factors between the two groups were comparable (Park et al, 2010). In line with our findings, Fregnani et al (2008) found no significant difference in survival between earlystage patients with ADC and SCC with 5-year disease-free survival of 87.9% and 85.7% (p=0.488), respectively. In this study, the authors also found lower histological grade, lower rate of lymphovascular space invasion, deeper stromal invasion and lymph node metastasis in patients with ADC compared with those with SCC (Fregnani et al, 2008).…”

Section: Discussionsupporting

confidence: 83%

“…In line with our findings, Fregnani et al (2008) found no significant difference in survival between earlystage patients with ADC and SCC with 5-year disease-free survival of 87.9% and 85.7% (p=0.488), respectively. In this study, the authors also found lower histological grade, lower rate of lymphovascular space invasion, deeper stromal invasion and lymph node metastasis in patients with ADC compared with those with SCC (Fregnani et al, 2008). These findings could suggest the influence of other high-risk pathological factors rather than histology at early stage of disease.…”

Section: Discussionsupporting

confidence: 80%

“…A US study of patients from 1997 to 2003 in the SEER database found 5-year overall survivals of 32.5% for patients with SNEC, 74.3% for ADC and 64.6% for SCC (Chen et al, 2008). Some studies have reported 2.6-2.9 times higher mortality among patients with early stage ADC compared with early-stage SCC patients over 10-19 years of follow-up (Nakanishi et al, 2000;Takeda et al, 2002;Park et al, 2010;Mabuchi et al, 2012) while others have not found any significant difference in survival among patients with SCC and ADC (Shingleton et al, 1995;Lee et al, 2006;Fregnani et al, 2008;Kasamatsu et al, 2009;Narukon et al, 2010). Moreover, only few studies have included patients with SNEC.…”

Section: Introductionmentioning

confidence: 99%

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Prognostic Impact of Histology in Patients with Cervical Squamous Cell Carcinoma, Adenocarcinoma and Small Cell Neuroendocrine Carcinoma

Intaraphet

Kasatpibal²,

Siriaunkgul³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Cervical cancer is the third most common cancer among women worldwide, accounting for approximately 13% of all cancers in women, with 529,800 new cases and 275,100 deaths in 2008. More than 85% of the cases and about 88% of all deaths occurred in developing countries (Ferlay, 2010;Jemal et al., 2011). At the same time, the incidence of cervical cancer has decreased dramatically in developed countries with well-developed screening programs concomitant with substantial survival AbstractBackground: Clarifying the prognostic impact of histological type is an essential issue that may influence the treatment and follow-up planning of newly diagnosed cervical cancer cases. This study aimed to evaluate the prognostic impact of histological type on survival and mortality in patients with cervical squamous cell carcinoma (SCC), adenocarcinoma (ADC) and small cell neuroendocrine carcinoma (SNEC). Materials and Methods: All patients with cervical cancer diagnosed and treated at Chiang Mai University Hospital between January 1995 and October 2011 were eligible. We included all patients with SNEC and a random weighted sample of patients with SCC and ADC. We used competing-risks regression analysis to evaluate the association between histological type and cancer-specific survival and mortality. Results: Of all 2,108 patients, 1,632 (77.4%) had SCC, 346 (16.4%) had ADC and 130 (6.2%) had SNEC. Overall, five-year cancer-specific survival was 60.0%, 54.7%, and 48.4% in patients with SCC, ADC and SNEC, respectively. After adjusting for other clinical and pathological factors, patients with SNEC and ADC had higher risk of cancer-related death compared with SCC patients (hazard ratio [HR] 2.6; 95% CI, 1.9-3.5 and HR 1.3; 95% CI, 1.1-1.5, respectively). Patients with SNEC were younger and had higher risk of cancer-related death in both early and advanced stages compared with SCC patients (HR 4.9; 95% CI, 2.7-9.1 and HR 2.5; 95% CI, 1.7-3.5, respectively). Those with advanced-stage ADC had a greater risk of cancer-related death (HR 1.4; 95% CI, 1.2-1.7) compared with those with advanced-stage SCC, while no significant difference was observed in patients with early stage lesions. Conclusion: Histological type is an important prognostic factor among patients with cervical cancer in Thailand. Though patients with SNEC were younger and more often had a diagnosis of early stage compared with ADC and SCC, SNEC was associated with poorest survival. ADC was associated with poorer survival compared with SCC in advanced stages, while no difference was observed at early stages. Further tailored treatment-strategies and follow-up planning among patients with different histological types should be considered.

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Cervical cancer histology and tumor differentiation affect ¹⁸F‐fluorodeoxyglucose uptake

Kidd

Spencer

Huettner

et al. 2009

Cancer

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BACKGROUND: This study aimed to evaluate the variation in cervical cancer glucose metabolism for different tumor histologies and levels of differentiation, as measured by the uptake of 18F‐fluorodeoxyglucose (FDG) by positron emission tomography (PET). METHODS: The study population consisted of 240 patients with International Federation of Gynecology and Obstetrics stages Ib1 through IVb cervical cancer, who underwent a pretreatment FDG‐PET. Tumor histology included 221 squamous cell (SC), 4 adenosquamous (AS), and 15 adenocarcinoma (AC) tumors. There were 14 well, 145 moderately, and 81 poorly differentiated tumors. The stage distribution was as follows: 70 stage I tumors (9 AC, 2 AS, and 59 SC), 102 stage II tumors (3 AC, 1 AS, and 98 SC), 64 stage III tumors (3 AC, 1 AS, and 60 SC), and 4 stage IV tumors (4 SC). From the FDG‐PET, maximal standardized uptake value (SUVmax) was determined. The variation in SUVmax was analyzed for differences based on tumor histology and differentiation. RESULTS: For all patients, the mean SUVmax was 11.62 (range, 2.50‐50.39). The mean SUVmax by histology was as follows: SC, 11.91 (range, 2.50‐50.39); AS, 8.85 (range, 6.53‐11.26); and AC, 8.05 (range, 2.83‐13.92). Squamous versus nonsquamous tumors demonstrated a significant difference in SUVmax (P = .0153). SUVmax and tumor volume were not found to be correlated (R2 = 0.013). The mean SUVmax was 8.58 for well‐differentiated, 11.56 for moderately differentiated, and 12.23 for poorly differentiated tumors. The mean SUVmax was significantly different for well‒differentiated versus poorly differentiated cervical tumors (P = .0474). CONCLUSIONS: Cervical tumor FDG uptake varied by histology and differentiation. SC tumors demonstrated a significantly higher SUVmax compared with nonsquamous cell tumors, and poorly differentiated tumors also had a higher SUVmax. Cancer 2009. © 2009 American Cancer Society.

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Comparison of biological behavior between early-stage adenocarcinoma and squamous cell carcinoma of the uterine cervix

Cited by 27 publications

References 25 publications

Outcomes after radical hysterectomy in patients with early-stage adenocarcinoma of uterine cervix

Outcomes after radical hysterectomy in patients with early-stage adenocarcinoma of uterine cervix

Prognostic Impact of Histology in Patients with Cervical Squamous Cell Carcinoma, Adenocarcinoma and Small Cell Neuroendocrine Carcinoma

Cervical cancer histology and tumor differentiation affect ¹⁸F‐fluorodeoxyglucose uptake

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Comparison of biological behavior between early-stage adenocarcinoma and squamous cell carcinoma of the uterine cervix

Cited by 27 publications

References 25 publications

Outcomes after radical hysterectomy in patients with early-stage adenocarcinoma of uterine cervix

Outcomes after radical hysterectomy in patients with early-stage adenocarcinoma of uterine cervix

Prognostic Impact of Histology in Patients with Cervical Squamous Cell Carcinoma, Adenocarcinoma and Small Cell Neuroendocrine Carcinoma

Cervical cancer histology and tumor differentiation affect 18F‐fluorodeoxyglucose uptake

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Cervical cancer histology and tumor differentiation affect ¹⁸F‐fluorodeoxyglucose uptake