Adenocarcinoma histology is a poor prognostic factor in locally advanced cervical cancer

Jońska-Gmyrek, Joanna; Gmyrek, Leszek; Żółciak-Siwińska, Agnieszka; Kowalska, M; Kotowicz, Beata

doi:10.1080/03007995.2018.1502166

Cited by 17 publications

(17 citation statements)

References 42 publications

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“…Cervical cancer patients with a low expression of ITM2A were more likely have adenocarcinoma or adenosquamous carcinoma, while cervical cancer patients with a high expression of ITM2A tended have squamous carcinoma. Compared with squamous cell carcinoma, cervical adenocarcinoma has a worse outcome [48,49]. Our study found that the low expression of ITM2A was associated with poor prognosis and cervical…”

Section: Discussionmentioning

confidence: 50%

A Five-Genes-Based Prognostic Signature for Cervical Cancer Overall Survival Prediction

Zhao

Huang

Zou

et al. 2020

International Journal of Genomics

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Aims. This study is aimed at identifying a prognostic signature for cervical cancer. Main Methods. The gene expression data and clinical information of cervical cancer and normal cervical tissues were acquired from The Cancer Genome Atlas and from three datasets of the Gene Expression Omnibus database. DESeq2 and Limma were employed to screen differentially expressed genes (DEGs). The overlapping DEGs among all datasets were considered the final DEGs. Then, the functional enrichment analysis was performed. Moreover, the Cox proportional hazards regression was performed to establish a prognostic signature of the DEGs. The Kaplan-Meier analysis was applied to test the model. Relationships between gene expression and clinicopathological parameters in cervical cancer, including age, HPV status, histology, stage, and lymph node metastasis, were analysed by the chi-square test. The somatic mutations of these prognostic genes were assessed through cBioPortal. The robustness of the model was verified in another two independent validation cohorts. Key Findings. In total, 169 overlapping upregulated genes and 29 overlapping downregulated genes were identified in cervical cancer compared with normal cervical tissues. Functional enrichment analysis indicated that the DEGs were mainly enriched in DNA replication, the cell cycle, and the p53 signalling pathway. Finally, a 5-gene- (ITM2A, DSG2, SPP1, EFNA1, and MMP1) based prognostic signature was built. According to this model, each patient was given a prognostic-related risk value. The Kaplan-Meier analysis showed that a higher risk was related to worse overall survival in cervical cancer, with an area under the receiver operating characteristic curve of 0.811 for 15 years. The validity of this model in the prediction of cervical cancer outcome was verified in another two independent datasets. In addition, our study also found that the low expression of ITM2A was associated with cervical adenocarcinoma. Interestingly, DSG2 was associated with the HPV status of cervical cancer. Significance. Our study constructed a prognostic model in cervical cancer and discovered two novel genes, ITM2A and DSG2, associated with cervical carcinogenesis and survival.

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Section: Discussionmentioning

confidence: 50%

A Five-Genes-Based Prognostic Signature for Cervical Cancer Overall Survival Prediction

Zhao

Huang

Zou

et al. 2020

International Journal of Genomics

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“…The influence of histology on the prognosis of cervical cancer has long been debated [ 19 , 20 ]. A study reported that adenocarcinoma had negative relation with the survival of advanced stage cervical cancer [ 21 ]. Tough FIGO stage system was widely used in clinical activities, the survival time of cervical cancer was diverse even with identical stage.…”

Section: Discussionmentioning

confidence: 99%

Calculating the overall survival probability in patients with cervical cancer: a nomogram and decision curve analysis-based study

et al. 2020

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Background: Cervical cancer has long been a common malignance troubling women. However, there are few studies developing nomogram with comprehensive factors for the prognosis of cervical cancer. Hence, we aimed to build a nomogram to calculate the overall survival (OS) probability in patients with cervical cancer. Methods: Data of 9876 female patients in SEER database and diagnosed as cervical cancer during 2010-2015, was retrospectively analyzed. Univariate and multivariate Cox proportional hazard regression model were applied to select predicted factors and a nomogram was developed to visualize the prediction model. The nomogram was compared with the FIGO stage prediction model. Harrell's C-index, receiver operating curve, calibration plot and decision curve analysis were used to assess the discrimination, accuracy, calibration and clinical utility of the prediction models. Result: Eleven independent prognostic variables, including age at diagnosis, race, marital status at diagnosis, grade, histology, tumor size, FIGO stage, primary site surgery, regional lymph node surgery, radiotherapy and chemotherapy, were used to build the nomogram. The C-index of the nomogram was 0.826 (95% CI: 0.818 to 0.834), which was better than that of the FIGO stage prediction model (C-index: 0.785, 95% CI: 0.776 to 0.793). Calibration plot of the nomogram was well fitted in 3-year overall OS prediction, but overfitting in 5-year OS prediction. The net benefit of the nomogram was higher than the FIGO prediction model. Conclusion: A clinical useful nomogram for calculating the overall survival probability in cervical cancer patients was developed. It performed better than the FIGO stage prediction model and could help clinicians to choose optimal treatments and precisely predict prognosis in clinical care and research.

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“…According to many studies, patients with ADC exhibit worse survival outcomes than patients with SCC [ 17 18 ]. The Japan Society of Obstetrics and Gynecology collected and analyzed data from 15,698 patients with cervical cancer, and found that patients with SCC had a significantly better prognosis than patients with ADC (p=0.004); the 5-year OS rates were 80.4% and 75.7% for patients with SCC and ADC, respectively [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…Distant recurrence had poorer survival compared with patients with locoregional or lymphatic recurrence. Some investigators have suggested that ADC is a distinct clinical entity from SCC and may be different at the molecular level [ 17 20 ]. This situation, taken as a whole, our results suggest that ADC associated with worse survival than SCC even after PSM.…”

Section: Discussionmentioning

confidence: 99%

Does adenocarcinoma have a worse prognosis than squamous cell carcinoma in patients with cervical cancer? A real-world study with a propensity score matching analysis

et al. 2020

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Objective To compare survival outcomes between cervical adenocarcinoma (ADC) and squamous cell carcinoma (SCC) using a propensity score matching (PSM) analysis based on the Surveillance, Epidemiology, and End Results (SEER) Program. Methods Patients diagnosed with cervical cancer between 1998 and 2016 were identified from the SEER database. The Kaplan-Meier method and Cox regression analysis were used to analyze survival. A subgroup analysis of overall survival (OS) between patients with ADC and SCC was performed after the 1:1 PSM analysis. Results Of the 33,148 patients, 24,591 (79.19%) had SCC and 8,557 (25.81%) had ADC. In the unmatched cohort, after adjustment in multivariate analysis, patients with ADC had a worse prognosis than patients with SCC (hazard ratio [HR]=1.12; 95% confidence interval [CI]=1.07–1.18; p<0.001). In the propensity matched cohort, Kaplan-Meier analysis and subgroup analysis showed that ADC was associated with a worse prognosis than SCC (p=0.001). An analysis stratified by SEER stage revealed a worse prognosis for patients with ADC patients presenting with a regional disease than patients with SCC (HR=1.24; 95% CI=1.14–1.36 p<0.001), but no statistically significant differences were observed between the localized disease (HR=0.97; 95% CI=0.86–1.10; p=0.664) and distant disease (HR=1.09; 95% CI=0.97–1.22; p=0.162) subgroups. Conclusion The significant differences in survival outcomes between patients with cervical ADC and SCC were only observed in the regional disease subgroup, but not in the localized disease and distant disease subgroups.

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Adenocarcinoma histology is a poor prognostic factor in locally advanced cervical cancer

Abstract: Adenocarcinoma histology negatively impacts OS and RFS for advanced cervical cancer. Histology-specific therapy may be an opportunity for survival improvement in these women.

Cited by 17 publications

References 42 publications

A Five-Genes-Based Prognostic Signature for Cervical Cancer Overall Survival Prediction

A Five-Genes-Based Prognostic Signature for Cervical Cancer Overall Survival Prediction

Calculating the overall survival probability in patients with cervical cancer: a nomogram and decision curve analysis-based study

Does adenocarcinoma have a worse prognosis than squamous cell carcinoma in patients with cervical cancer? A real-world study with a propensity score matching analysis

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