What is the difference between squamous cell carcinoma and adenocarcinoma of the cervix? A matched case–control study

Lee, K.Bm.; Lee, J.M.; Park, C.Y.; Lee, K.B.; Cho, H.Y.; Ha, Seung Yeon

doi:10.1111/j.1525-1438.2006.00628.x

Cited by 63 publications

(48 citation statements)

References 25 publications

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“…Grisaru et al (2001) reported that 799 surgically treated patients with FIGO stage IA -IB disease of AC or SCC had a similar prognosis. Look et al (1996) and Lee et al (2006) reported same results in 749 and 60 patients with FIGO stage IB disease, respectively. A similar finding was noted in a study from Fregnani et al (2008), in which 238 FIGO stage IB -IIA patients with AC or SCC were assessed.…”

Section: Spread Pattern and Failure Sitessupporting

confidence: 69%

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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 Sitessupporting

confidence: 69%

“…In the reported literature, no differences were found in positive lymph node rates of FIGO stage IB disease, and positive rates were approximately 5 -15% (Look et al, 1996;Irie et al, 2000;Lee et al, 2006). Few reported literature have discussed lymph node status of advanced stage, that is, FIGO stage IIB.…”

Section: Spread Pattern and Failure Sitesmentioning

confidence: 87%

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

et al. 2009

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“…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%

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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“…Lee et al and other researchers have shown that patients with early-stage AC who are treated surgically have a very poor prognosis 8 . However, other investigators have been unable to find this difference in survival between distinct histologic types 12 .…”

Section: Introductionmentioning

confidence: 94%