Comparison of clinical outcomes of adenocarcinoma and adenosquamous carcinoma in uterine cervical cancer patients receiving surgical resection followed by radiotherapy: A multicenter retrospective study (KROG 13-10)

Jae Myoung Noh, Won Park, Young Seok Kim, Joo Young Kim, Hak Jae Kim, Juree Kim, Jin Hee Kim, Mee Sun Yoon, Jin Hwa Choi, Won Sup Yoon, Ji Yoon Kim, Seung Jae Huh

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Abstract

Objective To evaluate the prognostic influence of adenocarcinoma (AC) and adenosquamous carcinoma (ASC) in patients with FIGO stage IB-IIA cervical cancer who received radical hysterectomy followed by adjuvant radiotherapy (RT) or concurrent chemoradiotherapy (CCRT). Methods We analyzed 1323 patients who satisfied the following criteria: histologically proven squamous cell carcinoma (SCC), AC, or ASC of the uterine cervix; FIGO stage IB-IIA disease; no history of neoadjuvant chemotherapy; and a history of radical hysterectomy with pelvic lymph node (PLN) dissection, followed by postoperative pelvic RT at a dose ≥ 45 Gy. The median age was 50 years. Median RT dose delivered to the whole pelvis was 50.4 Gy, and 219 (16.6%) patients received brachytherapy at a median dose of 24 Gy. Concurrent chemotherapy was delivered to 492 (37.2%) patients. Results Pathologic risk factors were not different according to pathologic subtype. The median follow-up duration was 75.7 months. Locoregional recurrence-free survival, relapse-free survival (RFS), and overall survival were significantly affected by histology, tumor size, PLN metastasis, parametrial invasion, lymphovascular invasion, and deep stromal invasion. The 5-year RFS rates were 83.7%, 66.5%, and 79.6% in patients with SCC, AC, and ASC histology, respectively (P < 0.0001). By multivariate analysis, AC histology was the only significant prognostic factor affecting all survival outcomes. Conclusions AC histology was associated with poor survival outcomes in patients with FIGO stage IB-IIA cervical cancer who received adjuvant RT or CCRT. Prognosis of ASC histology was closer to that of SCC histology than that of AC histology.

Original languageEnglish
Pages (from-to)618-623
Number of pages6
JournalGynecologic Oncology
Volume132
Issue number3
DOIs
Publication statusPublished - 2014 Jan 1

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Adenosquamous Carcinoma
Uterine Cervical Neoplasms
Multicenter Studies
Histology
Adenocarcinoma
Radiotherapy
Retrospective Studies
Adjuvant Chemoradiotherapy
Survival
Squamous Cell Carcinoma
Adjuvant Radiotherapy
Chemoradiotherapy
Hysterectomy
Recurrence
Drug Therapy
Brachytherapy
Lymph Node Excision
Pelvis
Cervix Uteri
Multivariate Analysis

Keywords

  • Adenocarcinoma
  • Adenosquamous carcinoma
  • Cervical cancer
  • Postoperative radiotherapy

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynaecology

Cite this

Comparison of clinical outcomes of adenocarcinoma and adenosquamous carcinoma in uterine cervical cancer patients receiving surgical resection followed by radiotherapy : A multicenter retrospective study (KROG 13-10). / Noh, Jae Myoung; Park, Won; Kim, Young Seok; Kim, Joo Young; Kim, Hak Jae; Kim, Juree; Kim, Jin Hee; Yoon, Mee Sun; Choi, Jin Hwa; Yoon, Won Sup; Kim, Ji Yoon; Huh, Seung Jae.

In: Gynecologic Oncology, Vol. 132, No. 3, 01.01.2014, p. 618-623.

Research output: Contribution to journalArticle

Noh, Jae Myoung ; Park, Won ; Kim, Young Seok ; Kim, Joo Young ; Kim, Hak Jae ; Kim, Juree ; Kim, Jin Hee ; Yoon, Mee Sun ; Choi, Jin Hwa ; Yoon, Won Sup ; Kim, Ji Yoon ; Huh, Seung Jae. / Comparison of clinical outcomes of adenocarcinoma and adenosquamous carcinoma in uterine cervical cancer patients receiving surgical resection followed by radiotherapy : A multicenter retrospective study (KROG 13-10). In: Gynecologic Oncology. 2014 ; Vol. 132, No. 3. pp. 618-623.
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abstract = "Objective To evaluate the prognostic influence of adenocarcinoma (AC) and adenosquamous carcinoma (ASC) in patients with FIGO stage IB-IIA cervical cancer who received radical hysterectomy followed by adjuvant radiotherapy (RT) or concurrent chemoradiotherapy (CCRT). Methods We analyzed 1323 patients who satisfied the following criteria: histologically proven squamous cell carcinoma (SCC), AC, or ASC of the uterine cervix; FIGO stage IB-IIA disease; no history of neoadjuvant chemotherapy; and a history of radical hysterectomy with pelvic lymph node (PLN) dissection, followed by postoperative pelvic RT at a dose ≥ 45 Gy. The median age was 50 years. Median RT dose delivered to the whole pelvis was 50.4 Gy, and 219 (16.6{\%}) patients received brachytherapy at a median dose of 24 Gy. Concurrent chemotherapy was delivered to 492 (37.2{\%}) patients. Results Pathologic risk factors were not different according to pathologic subtype. The median follow-up duration was 75.7 months. Locoregional recurrence-free survival, relapse-free survival (RFS), and overall survival were significantly affected by histology, tumor size, PLN metastasis, parametrial invasion, lymphovascular invasion, and deep stromal invasion. The 5-year RFS rates were 83.7{\%}, 66.5{\%}, and 79.6{\%} in patients with SCC, AC, and ASC histology, respectively (P < 0.0001). By multivariate analysis, AC histology was the only significant prognostic factor affecting all survival outcomes. Conclusions AC histology was associated with poor survival outcomes in patients with FIGO stage IB-IIA cervical cancer who received adjuvant RT or CCRT. Prognosis of ASC histology was closer to that of SCC histology than that of AC histology.",
keywords = "Adenocarcinoma, Adenosquamous carcinoma, Cervical cancer, Postoperative radiotherapy",
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T1 - Comparison of clinical outcomes of adenocarcinoma and adenosquamous carcinoma in uterine cervical cancer patients receiving surgical resection followed by radiotherapy

T2 - A multicenter retrospective study (KROG 13-10)

AU - Noh, Jae Myoung

AU - Park, Won

AU - Kim, Young Seok

AU - Kim, Joo Young

AU - Kim, Hak Jae

AU - Kim, Juree

AU - Kim, Jin Hee

AU - Yoon, Mee Sun

AU - Choi, Jin Hwa

AU - Yoon, Won Sup

AU - Kim, Ji Yoon

AU - Huh, Seung Jae

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Objective To evaluate the prognostic influence of adenocarcinoma (AC) and adenosquamous carcinoma (ASC) in patients with FIGO stage IB-IIA cervical cancer who received radical hysterectomy followed by adjuvant radiotherapy (RT) or concurrent chemoradiotherapy (CCRT). Methods We analyzed 1323 patients who satisfied the following criteria: histologically proven squamous cell carcinoma (SCC), AC, or ASC of the uterine cervix; FIGO stage IB-IIA disease; no history of neoadjuvant chemotherapy; and a history of radical hysterectomy with pelvic lymph node (PLN) dissection, followed by postoperative pelvic RT at a dose ≥ 45 Gy. The median age was 50 years. Median RT dose delivered to the whole pelvis was 50.4 Gy, and 219 (16.6%) patients received brachytherapy at a median dose of 24 Gy. Concurrent chemotherapy was delivered to 492 (37.2%) patients. Results Pathologic risk factors were not different according to pathologic subtype. The median follow-up duration was 75.7 months. Locoregional recurrence-free survival, relapse-free survival (RFS), and overall survival were significantly affected by histology, tumor size, PLN metastasis, parametrial invasion, lymphovascular invasion, and deep stromal invasion. The 5-year RFS rates were 83.7%, 66.5%, and 79.6% in patients with SCC, AC, and ASC histology, respectively (P < 0.0001). By multivariate analysis, AC histology was the only significant prognostic factor affecting all survival outcomes. Conclusions AC histology was associated with poor survival outcomes in patients with FIGO stage IB-IIA cervical cancer who received adjuvant RT or CCRT. Prognosis of ASC histology was closer to that of SCC histology than that of AC histology.

AB - Objective To evaluate the prognostic influence of adenocarcinoma (AC) and adenosquamous carcinoma (ASC) in patients with FIGO stage IB-IIA cervical cancer who received radical hysterectomy followed by adjuvant radiotherapy (RT) or concurrent chemoradiotherapy (CCRT). Methods We analyzed 1323 patients who satisfied the following criteria: histologically proven squamous cell carcinoma (SCC), AC, or ASC of the uterine cervix; FIGO stage IB-IIA disease; no history of neoadjuvant chemotherapy; and a history of radical hysterectomy with pelvic lymph node (PLN) dissection, followed by postoperative pelvic RT at a dose ≥ 45 Gy. The median age was 50 years. Median RT dose delivered to the whole pelvis was 50.4 Gy, and 219 (16.6%) patients received brachytherapy at a median dose of 24 Gy. Concurrent chemotherapy was delivered to 492 (37.2%) patients. Results Pathologic risk factors were not different according to pathologic subtype. The median follow-up duration was 75.7 months. Locoregional recurrence-free survival, relapse-free survival (RFS), and overall survival were significantly affected by histology, tumor size, PLN metastasis, parametrial invasion, lymphovascular invasion, and deep stromal invasion. The 5-year RFS rates were 83.7%, 66.5%, and 79.6% in patients with SCC, AC, and ASC histology, respectively (P < 0.0001). By multivariate analysis, AC histology was the only significant prognostic factor affecting all survival outcomes. Conclusions AC histology was associated with poor survival outcomes in patients with FIGO stage IB-IIA cervical cancer who received adjuvant RT or CCRT. Prognosis of ASC histology was closer to that of SCC histology than that of AC histology.

KW - Adenocarcinoma

KW - Adenosquamous carcinoma

KW - Cervical cancer

KW - Postoperative radiotherapy

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