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Comparison of the Prognoses of FIGO Stage I to Stage II Adenosquamous Carcinoma and Adenocarcinoma of the Uterine Cervix Treated With Radical Hysterectomy
  1. Seiji Mabuchi, MD, PhD*,,
  2. Mika Okazawa, MD,,
  3. Yasuto Kinose, MD*,
  4. Koji Matsuo, MD§,
  5. Masateru Fujiwara, MD,
  6. Osamu Suzuki, MD, PhD,
  7. Eiichi Morii, MD, PhD,
  8. Shoji Kamiura, MD, PhD,
  9. Kazuhiko Ogawa, MD, PhD and
  10. Tadashi Kimura, MD, PhD*
  1. *Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine;
  2. Department of Gynecology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan;
  3. §Division of Gynecologic Oncology, Los Angeles County Medical Center, University of Southern California, Los Angeles, CA;
  4. Department of Radiation Oncology, Osaka University Graduate School of Medicine;
  5. Department of Radiation Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases; and
  6. Department of Pathology, Osaka University Graduate School of Medicine Osaka, Japan.
  1. Address correspondence and reprint requests to Seiji Mabuchi, MD, PhD, Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan. E-mail: smabuchi{at}gyne.med.osaka-u.ac.jp.

Abstract

Objectives To evaluate the significance of adenosquamous carcinoma (ASC) compared with adenocarcinoma (AC) in the survival of surgically treated early-stage cervical cancer.

Methods We retrospectively reviewed the medical records of 163 patients with International Federation of Gynecology and Obstetrics stage IA2 to stage IIB cervical cancer who had been treated with radical hysterectomy with or without adjuvant radiotherapy between January 1998 and December 2008. The patients were classified according to the following: (1) histological subtype (ASC group or AC group) and (2) pathological risk factors (low-risk or intermediate/high-risk group). Survival was evaluated using the Kaplan-Meier method and compared using the log-rank test. Multivariate analysis of progression-free survival (PFS) was performed using the Cox proportional hazards regression model to investigate the prognostic significance of histological subtype.

Results Clinicopathological characteristics were similar between the ASC and AC histology groups. Patients with the ASC histology displayed a PFS rate similar to that of the patients with the AC histology in both the low-risk and intermediate/high-risk groups. Neither the recurrence rate nor the pattern of recurrence differed between the ASC group and the AC group. Univariate analysis revealed that patients with pelvic lymph node metastasis and parametrial invasion achieved significantly shorter PFS than those without these risk factors.

Conclusions Characteristics of the patients and the tumors as well as survival outcomes of ASC were comparable to adenocarcinoma of early-stage uterine cervix treated with radical hysterectomy. Our results in part support that the management of ASC could be the same as the one of AC of the uterine cervix.

  • Cervical cancer
  • Radical hysterectomy
  • Adenocarcinoma
  • Adenosquamous carcinoma
  • Survival

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Footnotes

  • This work was supported in part by a grant-in-aid for General Scientific Research No 23592446 from the Ministry of Education, Culture, Sports, Science, and Technology of Japan.

  • The authors declare no conflicts of interest.

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