Introduction/Background Villoglandular adenocarcinoma (VGA) of the uterine cervix is a rare tumour and has been classified as a variant of a cervical adenocarcinoma with good prognosis, but radical therapy still remains the standard treatment. Less invasive management could be an option.
Methodology Case series and case reports were identified by searching PubMed, and from references in relevant articles from 1989 (the year VGA was first described) to 2018. We used the search terms: ‘villoglandular’, ‘cervical cancer’, ‘adenocarcinoma’. The extracted data on tumour characteristics were: stage Ia-Ib1, Inos, LVSI status, specific surgical approach, pure VGA). Three patients were excluded because of a complex histology (VGA combined with underlying adenocarcinoma or squamous cell carcinoma).
Results fter exclusion for repeated publications, we identified 54 reports, involving 320 patients, in which VGA was analysed. 91 patients were excluded because of stage Ib2, II, III, unknown (48), no follow up data (n=40), and no pure VGA (n=3). A total of 229 patients was evaluated, 45 (20%) were treated by a ‘conservative management’ (conisation, simple hysterectomy, trachelectomy) and 184 (80%) by an ‘invasive management’ (radical hysterectomy with or without chemoradiationtherapy). Recurrences have been found in the ‘conservative group’ in one case (2,2%, ROD: 44 months) and in the ‘invasive group’ in 10 cases (5,4%), respectively (ROD: 12, 17, 22, 24, 34, 42, 42, 44, 61, ?(NED): 153 months). Four patients (2, 2%) died after ‘invasive therapy’ (DOD: ‘a few months later’, 42 months, ‘fifth year’, 79 months).
Conclusion The excellent prognosis of pure VGA and the young age of these patients are justifiable that this tumour may be managed by a less radical procedure. The histological diagnosis of VGA is a challenge and pre-treatment should not be based only on a simple punch biopsy but a conisation with widely tumour-free margins.
Disclosure Nothing to disclose.
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