Objectives Compare clinical outcomes of GAS, usual-type endocervical adenocarcinomas (UEA) and squamous cell carcinoma (SCC).
Methods Twenty-two cases of GAS, 44 cases of UEA and 66 cases of SCC matched by age and clinical stage were assessed. Diagnosis of GAS was based on the Kojima’s criteria and immunohistochemical results. Clinical parameters (age, clinical stage and clinical outcome after first-line treatment) were recorded. Descriptive and comparative analysis was conducted. Response to treatment was compared between groups. Overall Survival (OS) and Disease-Free survival (DFS) were calculated with Kaplan-Meier method, compared with Log- Rank test.
Results Mean age at diagnosis was 51 years (range 31–76). Five cases were clinical stage IB1 (22.7%), IB2 1 (4.5%), IIB 2 (9.1%), IIIB 4 (18.2%), IVA 2 (9.1%), IVB 8 (36.4%). The median follow-up was 23 months. GAS cases showed complete response to first-line treatment in 31.1% (n=7), partial response 18.2% (n=4), 40.9% (n=9) had persistence/progression of the disease, no statistical difference was observed when compared to other histologies (p=0.2). Progression-free survival was 85.7% without significant difference (p=0.9). The overall survival was 75% at 24 months, and comparable to SCC and UEA (p=0.6).
Conclusions GAS has clinical features that makes difficult to diagnose, most of the times being diagnosed at advance stages. Despite the review of the literature showing that this neoplasm has an aggressive clinical course and poorer response to conventional treatment, our study was not able to demonstrate this association, larger number of cases must be evaluated.
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