Introduction In general, adenocarcinoma of the cervix is known to have a worse prognosis than squamous cell carcinoma (SCC). The World Health Organization classification divides endocervical adenocarcinoma (ADC) into human papillomavirus (HPV)-associated (HPVA) and HPV-independent (HPVI) types in 2020. This study aimed to compare the prognosis of HPVA ADC, HPVI ADC, and SCC.
Methods We retrospectively reviewed the medical records of 185 patients with SCC, 61 patients with HPVA ADC, and 13 patients with HPVI ADC, who underwent radical hysterectomy and pelvic lymphadenectomy for cervical cancer 2018 FIGO stage IA2 – III from January 2005 to December 2016. Prognostic factors, recurrence rate, disease-free survival (DFS) and 5-year survival outcomes were compared between HPVA ADC, HPVI ADC and SCC.
Results The incidence of deep stromal invasion (≥middle or deep 1/3) was higher in HPVI ADC patients than in HPVA ADC and SCC patients (92.3%, 65.6%, 82.2%, P=0.0108). HPVI ADC was associated with a higher recurrence rate compared to HPVA ADC and SCC (46.2%, 19.7%, 15.1%, P=0.0166). HPVI ADC was associated with worse DFS compared with HPVA ADC, SCC (44.9 months, 127.9 months, 91.3 months, P=0.0123). HPVI ADC was associated with worse 5-year survival rate compared with HPVA ADC, SCC (69.2%, 85.2%, 91.9%, P=0.0207). There was no difference in 5-year survival rate between patients with HPVA ADC and patients with SCC.
Conclusion/Implications HPVI ADC had a poorer prognosis compared to HPVA ADC and SCC. However, there was no difference in prognosis between HPVA ADC and SCC in 2018 FIGO stage IA2 – III cervical cancer.
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