Early-stage node negative cervical adenocarcinoma and squamous cell carcinoma show similar survival outcomes after hysterectomy: a population-based study

다국어 초록 (Multilingual Abstract)

Objective: To investigate the clinicopathological features and outcomes between node-negative, early-stage cervical squamous cell carcinoma (SCC) and adenocarcinoma (AC) after hysterectomy.
Methods: Patients diagnosed with International Federation of Gynecology and Obstetrics (FIGO) stages I–IIA cervical SCC and AC between 1988 and 2013 were retrospectively reviewed using the Surveillance, Epidemiology, and End Results database. We used propensity score-matching to balance patient baseline characteristics. Univariate and multivariate Cox regression analyses were used for prognostic analyses of cause-specific survival (CSS) and overall survival (OS).
Results: A total of 9,858 patients were identified, comprising 6,117 patients (62.1%) and 3,741 (37.9%) patients with cervical SCC and AC, respectively. Compared with cervical SCC, cervical AC cases were more likely to be younger, diagnosed after 2000, white, and have well-differentiated and FIGO stage IB1 disease. For SCC and AC, the 10-year CSS rates were 93.4% and 94.7%, respectively (p=0.011), and the 10-year OS rates were 89.6% and 92.2%, respectively (p<0.001). Multivariate analysis revealed that age, ethnicity, tumor grade, and FIGO stage were independent prognostic factors of CSS and OS, but that histologic subtype was not associated with CSS and OS. In the propensity score-matched patient population, univariate and multivariate analyses also showed that histologic subtype was not associated with survival outcomes.
Conclusion: Cervical AC has equivalent survival to cervical SCC in node-negative, early-stage disease after hysterectomy and lymphadenectomy.

참고문헌 (Reference)

1 Zhou J, "The prognostic value of histologic subtype in node-positive early-stage cervical cancer after hysterectomy and adjuvant radiotherapy" 44 : 1-6, 2017

2 Winer I, "The prognostic significance of histologic type in early stage cervical cancer - a multi-institutional study" 137 : 474-478, 2015

3 Zhou J, "The effect of local treatment modalities in patients with early-stage adenocarcinoma of the uterine cervix: a population-based analysis" 41 : 16-22, 2017

4 National Cancer Institute, "Surveillance, Epidemiology, and End Results (SEER) Program (US). SEER*Stat Database: Incidence - SEER 9 regs research data, Nov 2015 Sub (1973–2013) %3CKatrina/Rita Population Adjustment%3E" National Cancer Institute

5 Mahawerawat S, "Surgical outcomes of patients with stage IA2 cervical cancer treated with radical hysterectomy" 14 : 5375-5378, 2013

6 Fabio Landoni, "Randomized study between radical surgery and radiotherapy for the treatment of stage IB–IIA cervical cancer: 20-year update" 대한부인종양학회 28 (28): 1-10, 2017

7 Landoni F, "Randomised study of radical surgery versus radiotherapy for stage IB-IIA cervical cancer" 350 : 535-540, 1997

8 Vinh-Hung V, "Prognostic value of histopathology and trends in cervical cancer: a SEER population study" 7 : 164-, 2007

9 Mao S, "Prognostic significance of number of nodes removed in patients with node-negative early cervical cancer" 42 : 1317-1325, 2016

10 Galic V, "Prognostic significance of adenocarcinoma histology in women with cervical cancer" 125 : 287-291, 2012

11 Intaraphet S, "Prognostic impact of histology in patients with cervical squamous cell carcinoma, adenocarcinoma and small cell neuroendocrine carcinoma" 14 : 5355-5360, 2013

12 Wang SS, "Pathological characteristics of cervical adenocarcinoma in a multi-center US-based study" 103 : 541-546, 2006

13 National Comprehensive Cancer Network (US), "NCCN Clinical Practice Guidelines in Oncology. Title" National Comprehensive Cancer Network

14 Huang YT, "Long-term outcome and prognostic factors for adenocarcinoma/adenosquamous carcinoma of cervix after definitive radiotherapy" 80 : 429-436, 2011

15 Rose PG, "Locally advanced adenocarcinoma and adenosquamous carcinomas of the cervix compared to squamous cell carcinomas of the cervix in gynecologic oncology group trials of cisplatin-based chemoradiation" 135 : 208-212, 2014

16 Mabuchi S, "Impact of histological subtype on survival of patients with surgically-treated stage IA2-IIB cervical cancer: adenocarcinoma versus squamous cell carcinoma" 127 : 114-120, 2012

17 Fujiwara H, "Gynecologic Cancer InterGroup (GCIG) consensus review for cervical adenocarcinoma" 24 : S96-101, 2014

18 Torre LA, "Global cancer incidence and mortality rates and trends--an update" 25 : 16-27, 2016

19 Kosary CL, "FIGO stage, histology, histologic grade, age and race as prognostic factors in determining survival for cancers of the female gynecological system: an analysis of 1973-87 SEER cases of cancers of the endometrium, cervix, ovary, vulva, and vagina" 10 : 31-46, 1994

20 Chen JL, "Differential clinical characteristics, treatment response and prognosis of locally advanced adenocarcinoma/adenosquamous carcinoma and squamous cell carcinoma of cervix treated with definitive radiotherapy" 93 : 661-668, 2014

21 Fujiwara K, "Devouassoux-Shisheboran M. Adenocarcinoma of the uterine cervix: why is it different?" 16 : 416-, 2014

22 Shimada M, "Comparison of the outcome between cervical adenocarcinoma and squamous cell carcinoma patients with adjuvant radiotherapy following radical surgery: SGSG/TGCU Intergroup Surveillance" 1 : 780-784, 2013

23 Zhou J, "Comparison of clinical outcomes of squamous cell carcinoma, adenocarcinoma, and adenosquamous carcinoma of the uterine cervix after definitive radiotherapy: a population-based analysis" 143 : 115-122, 2017

24 Mabuchi Y, "Clinicopathologic factors of cervical adenocarcinoma stages IB to IIB" 25 : 1677-1682, 2015

25 Huang YT, "Clinical behaviors and outcomes for adenocarcinoma or adenosquamous carcinoma of cervix treated by radical hysterectomy and adjuvant radiotherapy or chemoradiotherapy" 84 : 420-427, 2012

26 Parkin DM, "Chapter 2: the burden of HPV-related cancers" 24 (24): S3/11-25, 2006

27 Takeuchi S, "Biology and treatment of cervical adenocarcinoma" 28 : 254-262, 2016

28 Look KY, "An analysis of cell type in patients with surgically staged stage IB carcinoma of the cervix: a Gynecologic Oncology Group study" 63 : 304-311, 1996

29 Seki T, "Adjuvant therapy after radical surgery for stage IB-IIB cervical adenocarcinoma with risk factors" 47 : 32-38, 2017

30 Gien LT, "Adenocarcinoma: a unique cervical cancer" 116 : 140-146, 2010

31 Eifel PJ, "Adenocarcinoma as an independent risk factor for disease recurrence in patients with stage IB cervical carcinoma" 59 : 38-44, 1995

32 Hopkins MP, "A comparison of adenocarcinoma and squamous cell carcinoma of the cervix" 77 : 912-917, 1991