Clinical features and prognostic factors of cervical villoglandular adenocarcinoma

Abstract

BackgroundVilloglandular adenocarcinoma is a rare sub-type of cervical adenocarcinoma.ObjectiveTo analyze the clinicopathological features and evaluate the prognosis of patients with villoglandular adenocarcinoma of the cervix.MethodsPatient characteristics, procedure, pathology, and surgical outcomes were retrospectively reviewed in patients with villoglandular adenocarcinoma between November 2006 and June 2019 from multiple centers in China. In order to explore the difference between villoglandular adenocarcinoma and routine adenocarcinoma, patients (FIGO 2009 stage IA1–IB2) who had complete data during the same time period were included.ResultsA total of 60 patients with villoglandular adenocarcinoma and 104 with standard adenocarcinoma were included. The median age of the patients with villoglandular adenocarcinoma was 42 years (range 27–68). The most common 2009 FIGO stage was IB1 in 39 (65%) patients with villoglandular adenocarcinoma. A total of 23 patients underwent laparoscopic surgery (two total hysterectomies, 21 radical hysterectomies) and the other 37 patients underwent laparotomy (three total hysterectomies, 34 radical hysterectomies). A total of 56 patients underwent lymphadenectomy and three (5.4%) had positive lymph nodes. Fifteen (25%) patients had one or both ovaries preserved. Seven patients were lost to follow-up. The median follow-up time for the entire group was 50.2 months (range 5.1–154.6). No deaths or recurrences occurred. Excluding six patients with FIGO 2009 stage II, the 5-year disease-free survival of the 47 patients with villoglandular adenocarcinoma with FIGO 2009 stage I for whom there was follow-up, was significantly higher than that of the 104 patients with standard cervical adenocarcinoma (100% vs 92.2%, log-rank p=0.039). However, the 5-year overall survival of the two groups did not differ (100% vs 95.7%, log-rank p=0.11).ConclusionVilloglandular adenocarcinoma has a favorable prognosis. Further studies are needed to provide more details of treatment strategies and prognosis.

Is there different prognosis between cervical endometrioid adenocarcinoma and ordinary cervical adenocarcinoma in a propensity score matching study based on the surveillance, epidemiology, and end results (SEER) database?

“…However, our analysis revealed that there was no statistically significant difference in the survival outcomes of OS and DSS between the EC and AC patients, but the EC patients showed better survival than the AC patients. Similar to our findings, Chen found that villo-glandular AC has a favorable prognosis ( 22 ). We speculated that a number of possible factors may explain these inconsistent results.…”

“…Our HR study revealed that EC patients had better survival than AC patients. Some research has suggested that the prognosis of each AC varies according to its histopathological type ( 12 , 22 , 28 - 30 ). Some investigators have suggested that different subtypes of cervical AC may be different at the molecular level ( 31 , 32 ), Taken as a whole, from a clinical point of view, our results suggest that EC may be associated with better survival than AC even after PSM.…”

“…In this study, we used the 1:1 PSM method to match the Single/unmarried 612 [27] 71 [25] 67 [24] 71 [25] Regional 19-90 507 [22] 74 [26] 62 [22] 74 [26] Positive [29] 52 [19] 55 [20] 52 [19] 40-44 376 [17] 40 [14] 34 [12] 40 [14] 45-59 703 [31] 107 [38] 111 [40] 107 [38] 60-97 532 [23] 81 [29] 80 [29] 81 [29] AC Single/unmarried 611 [27] 71 [26] 67 [25] 71 [26] Regional 19-90 504 [22] 73 [27] 68 [25] 73 [27] Positive [29] 52 [19] 50 [18] 52 [19] 40-44 375 [17] 40 [15] 33 [12] 40 [15] 45-59 697 [31] 107 [39] 111 [41] 107 [39] 60-97 518 [23] 76 [28] 79 [29] 76 [28] AC, ordinary cervical adenocarcinoma; EC, cervical endometrioid adenocarcinoma; PSM, propensity score ...…”

Villoglandular adenocarcinoma of the uterine cervix: a systematic review and meta-analysis

“…In the present review, one positive lymph node was described in the invasive group in nine patients [11,12,22,24,25,[27][28][29], whereby four patients were LVI positive, one was negative; in two cases, LVI had not been determined. Six patients were irradiated postoperatively, and no recurrence occurred.…”

“…In nine patients, at least one affected lymph node could be detected [ 5 , 11 , 12 , 22 , 25 , 27 – 29 ], three showed a positive LVI [ 5 , 12 , 28 ], and three was LVI negative [ 27 , 29 ]. In two patients, LVI was not reported [ 22 , 25 ].…”