Comparison of adenocarcinoma and adenosquamous carcinoma prognoses in Chinese patients with FIGO stage IB-IIA cervical cancer following radical surgery

Zhang, Xiaojing; Lv, Zunfu; Xu, Ximing; Yin, Zhipeng; Lou, Hanyi

doi:10.1186/s12885-020-07148-x

Cited by 22 publications

(24 citation statements)

References 40 publications

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“…Zhou et al 14 found that patients with ADC were more likely to be well and moderately differentiated, while more ASC patients were poorly and undifferentiated. Zhang et al 10 recently found that, compared with ADC patients, patients with ASC tended to be older and have higher frequencies of LVSI and serum squamous cell carcinoma antigen (SCC-Ag) greater than 5 ng/mL. However, in our study, the incidence of pelvic lymph node metastasis in patients with ADC was higher than that in patients with ASC.…”

Section: Discussioncontrasting

confidence: 78%

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Comparison of Outcomes and Prognostic Factors Between Early-Stage Cervical Adenocarcinoma and Adenosquamous Carcinoma Patients After Radical Surgery and Postoperative Adjuvant Radiotherapy

Zhou¹,

Wang²,

Hu³

et al. 2021

CMAR

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Purpose:No consensus has been reached regarding the survival difference between cervical adenocarcinoma (ADC) and adenosquamous carcinoma (ASC) patients. The purpose of this study was to compare survival outcomes and prognostic factors between early-stage ADC and ASC patients. Patients and Methods: We retrospectively reviewed stage IB-IIA patients with ADC and ASC who underwent radical hysterectomy and postoperative radiotherapy between June 2012 and December 2017. Results: A total of 125 patients were enrolled in our study (97 with ADC and 28 with ASC). The median follow-up period was 53.4 months. Compared with ASC patients, patients with ADC tended to have a higher proportion of positive pelvic lymph nodes (7.1% and 26.8%, respectively; p = 0.028). The most common site of distant metastasis was the lung, followed by the intestine and colon. The 5-year overall survival (OS), disease-free survival (DFS), pelvic control, and distant control rates for ADC and ASC patients were 83.6% and 92.0% (p = 0.349), 77.5% and 87.7% (p = 0.279), 81.8% and 96.2% (p = 0.121), and 88.3% and 87.7% (p = 0.948), respectively. Parametrial invasion was a prognostic factor for OS. Lymphovascular space involvement was a prognostic factor for DFS. Conclusion: ADC patients were more likely to have positive pelvic lymph nodes than those with ASC. There was no significant difference in survival outcomes between patients with ADC and ASC.

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Section: Discussioncontrasting

confidence: 78%

“…Early studies have shown that compared with ADC patients, ASC patients tended to have a lower 5-year DFS rate and shorter interval of disease recurrence. 8,9 However, Zhang et al 10 recently compared the outcome between ADC and ASC patients, which showed no significant prognostic difference.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Outcomes and Prognostic Factors Between Early-Stage Cervical Adenocarcinoma and Adenosquamous Carcinoma Patients After Radical Surgery and Postoperative Adjuvant Radiotherapy

Zhou¹,

Wang²,

Hu³

et al. 2021

CMAR

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“…Currently, ASC type group includes glassy cell carcinoma and mucoepidermoid carcinoma. 12,[26][27][28][29][30] Data confirm the monoclonal origin of ASC, differentiating it as a distinct biological entity from both SCC and AC. 31 Precursors to this carcinoma type are high-grade squamous intraepithelial lesion (HSIL) and adenocarcinoma in situ (ACIS) with frequent detection of Human Papilloma Virus types 16 and 18 related to them.…”

Section: Discussionmentioning

confidence: 93%

Adenosquamous Carcinoma of the Uterine Cervix – Impact of Histology on Clinical Management

Yordanov

Kostov

Slavchev

et al. 2021

CMAR

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Introduction Historically, the incidence rate of cervical cancer (CC) in Eastern Europe and particularly in Bulgaria has constantly been higher than that in the other European countries. Adenosquamous carcinoma (ASC) is a rare histological subtype of CC with incidence rate of less than 6 per 100,000. We aimed to analyze the epidemiology and prognosis of all Bulgarian patients with ASC, registered at the Bulgarian National Cancer Registry (BNCR), and to compare patients’ characteristics and outcomes with those of patients, treated at a large specialized institution – the Department of Gynecologic Oncology, University Hospital in Pleven, Bulgaria. Materials and Methods This is a retrospective study of all cases of ASC, registered at the BNCR for a 10-year period of time. The Kaplan–Meier analysis with Log rank test was used to estimate the significant differences. Results The incidence rate of ASC was calculated as 3.2% of all CC registered in BNCR and 4.97% of all stage I patients, treated in our department. The 5-year overall survival (OS) rate of all patients with ASC tumors from the registry was 50.5%. A total of 171 (48.4%) of the patients had T1 tumors and a 5-year OS of 67.1%. Lymph node status was a significant prognostic factor for OS (p=0.001). Thirty-one patients with T1 tumors and ASC histology were treated in our department for the same period of time. Lymph node metastases were found in 10 of them (32.2%). The 5-year observed OS in ASC group was 74.19%. Conclusion The histological subtype of cancer of the uterine cervix has an impact on prognosis and should not be simply considered as a descriptive characteristic but a poor prognostic feature and should be an integral part of the decision-making in clinical management of patients.

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“…Regarding cervical ADC, limited reports are available for serum tumor markers, including carbohydrate antigen-125 (CA125), CA 19-9, and carcinoembryonic antigen [ 9 10 11 12 ]. Among aforementioned markers, CA125 has been established as an important marker in the diagnosis and monitoring of other gynecologic tumors, such as ovarian and endometrial cancer [ 12 13 14 15 ]. Although several reports have noted its significance in cervical cancer, the reports included heterogeneous groups of patients, including those with both ADC and adenosquamous cell carcinoma, and patients treated with either definitive RT or adjuvant RT.…”

Section: Introductionmentioning

confidence: 99%

Significance of serum CA125 level in surgically resected cervical adenocarcinoma with adverse features

et al. 2021

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Objective Unlike cervical squamous cell carcinoma, there are no consensus criteria for serum tumor markers in cervical adenocarcinoma. This study aimed to identify the prognostic value of preoperative carbohydrate antigen 125 (CA125) levels in cervical adenocarcinoma patients with adverse pathologic features. Methods A total of 105 patients who underwent radical hysterectomy followed by adjuvant radiotherapy (RT) or concurrent chemoradiation therapy were included. Locoregional recurrence-free survival (LRFS), distant metastasis-free survival (DMFS), and overall survival (OS) were evaluated using the Cox proportional hazard regression model. Results Using a cutoff value of 50 U/mL, 83 and 22 patients had low- and high-CA125, respectively. Patients with high-CA125 had a larger tumor size, more frequent parametrial extension, and more frequent lymph node metastasis than those with low-CA125. During a median follow-up of 59.3 (interquartile range, 32.7–97.8) months, patients with high-CA125 showed inferior 5-year LRFS, DMFS, and OS rates compared to those with low-CA125 (38.5% vs. 70.0%; 37.0% vs. 69.4%; 43.6% vs. 78.1%, respectively, all p<0.05). In multivariable analysis, the high-CA125 remained significant prognostic factor for LRFS, DMFS, and OS (all p<0.05). Furthermore, 12 patients with high-CA125 at recurrence exhibited lower 5-year OS rates than 21 patients with low-CA125 at recurrence (0.0% vs. 51.3%, p=0.003). Conclusion In this retrospective analysis, the serum CA125 level at diagnosis and recurrence was related to the extent of disease and prognosis of cervical adenocarcinoma with adverse pathologic features. A CA125 level of ≥50 U/mL may be a prognostic surrogate marker for cervical adenocarcinoma in patients with the presence of adverse factors.

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Comparison of adenocarcinoma and adenosquamous carcinoma prognoses in Chinese patients with FIGO stage IB-IIA cervical cancer following radical surgery

Cited by 22 publications

References 40 publications

Comparison of Outcomes and Prognostic Factors Between Early-Stage Cervical Adenocarcinoma and Adenosquamous Carcinoma Patients After Radical Surgery and Postoperative Adjuvant Radiotherapy

Comparison of Outcomes and Prognostic Factors Between Early-Stage Cervical Adenocarcinoma and Adenosquamous Carcinoma Patients After Radical Surgery and Postoperative Adjuvant Radiotherapy

Adenosquamous Carcinoma of the Uterine Cervix – Impact of Histology on Clinical Management

Significance of serum CA125 level in surgically resected cervical adenocarcinoma with adverse features

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