Gastric-Type Adenocarcinoma of the Uterine Cervix Associated with Poor Response to Definitive Radiotherapy

Kuruma, Airi; Kodama, Michiko; Hori, Yumiko; Sato, Kazuaki; Fujii, Makoto; Isohashi, Fumiaki; Miyoshi, Anderson; Mabuchi, Seiji; Setoguchi, Akira; Shimura, Hiroko; Goto, Takeshi; Toda, Aska; Nakagawa, Satoshi; Kinose, Yasuto; Takiuchi, Tsuyoshi; Kobayashi, Eiji; Hashimoto, Kae; Ueda, Yutaka; Sawada, Kenjiro; Morii, Eiichi; Kimura, Tadashi

doi:10.3390/cancers15010170

Cited by 6 publications

(2 citation statements)

References 36 publications

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“…[12] In the treatment of chemotherapy, compared to non-gastric-type endocervical AC, the 3-year OS rate and the PFS rate both lower (50.0% vs 78.4%, P = .18, 44.4% vs 66.7%, P < .05, respectively). [13]…”

Section: Discussionmentioning

confidence: 99%

A case of endocervical adenocarcinoma of the gastric type that was repeatedly misdiagnosed: A case report and literature review

et al. 2023

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Rationale: Gastric-type endocervical adenocarcinoma (GAS) is non-human papillomavirus-associated cervical cancer and the location of the lesions is in the cervical canal mostly.Patient concerns: Vaginal discharge is mistakenly thought to be caused by uterine fibroids. Misdiagnosis leads to disease progression.Diagnoses: Magnetic resonance imaging is an auxiliary tool and pathology is the gold standard for the diagnosis.Interventions: Surgery and supplementary radiotherapy and chemotherapy ± targeted therapy are the main treatment methods.Outcomes: GAS with high malignant degree poor prognosis and insidious development, tends to develop toward the cervical canal and is lack of specific tumor markers, so it is easy to misdiagnosis and missed diagnosis.Lessons: This case highlights the importance of improving the understanding of GAS. And when patients perform vaginal discharge, cervical canal hypertrophy, and cervical cancer screening negative, clinicians ought to be highly alert to GAS.

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Section: Discussionmentioning

confidence: 99%

A case of endocervical adenocarcinoma of the gastric type that was repeatedly misdiagnosed: A case report and literature review

et al. 2023

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“…Compared with HPV‐associated ECA, GEA has higher prevalence of destructive invasion, extrauterine spread, and advanced stage at presentation [ 1 , 5 ]. GEA is also associated with poor response to chemoradiation treatment [ 6 , 7 ] and significantly worse disease‐free and overall survival [ 1 , 5 , 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Expression of B7‐H3 and TIM‐3 in gastric‐type endocervical adenocarcinoma: prevalence, association with PD‐L1 expression, and prognostic significance

Sun,

Zhou,

Lucas

et al. 2023

The Journal of Pathology CR

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Gastric‐type endocervical adenocarcinoma (GEA) is the second most common subtype of endocervical adenocarcinoma and has a poor prognosis. Anti‐programmed death‐1 and anti‐programmed death‐ligand 1 (PD‐L1) inhibitors have emerged as a major treatment option for GEA; however, data on the expression of other immune checkpoints in GEA are limited. We analyzed the expression of T‐cell immunoglobulin and mucin‐domain containing‐3 (TIM‐3) and B7 homolog 3 protein (B7‐H3) in 58 GEA and investigated their prognostic significance as well as association with PD‐L1 expression and other known prognostic factors. Applying the tumor proportion score (TPS) with a cutoff of 1%, B7‐H3 and TIM‐3 were present in 48.3% and 17.2% of cases, respectively. Applying the combined positive score (CPS) with a cutoff of 1, TIM‐3 expression was present in 70.7% of cases. Moreover, the expression of three checkpoints (B7‐H3, TIM‐3, and PD‐L1) was incompletely overlapping. Patients with B7‐H3 positive tumors (by TPS) or TIM‐3 positive tumors (by TPS) had significantly worse recurrence‐free survival (RFS) and overall survival (OS) (log‐rank). Using CPS, patients with TIM‐3 positive tumors showed significantly worse RFS (log‐rank). Similarly, B7‐H3 positivity (by TPS) and TIM‐3 positivity (by TPS) were associated with worse RFS and OS in univariate analysis. TIM‐3 positivity (by CPS) was associated with worse RFS in univariate analysis and the final Cox multivariate analysis. In conclusion, our results show that (1) B7‐H3 and TIM‐3 are frequently expressed in GEA and their expression overlaps incompletely with PD‐L1; and (2) both B7‐H3 and TIM‐3 are independent negative prognostic markers in GEA.

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Limited diagnostic performance of imaging evaluation for staging in gastric-type endocervical adenocarcinoma: a multi-center study

Himoto,

Kido,

Yamanoi

et al. 2024

Jpn J Radiol

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Purpose The purposes of the study are to assess the diagnostic performance of preoperative imaging for staging factors in gastric-type endocervical adenocarcinoma (GEA) and to compare the performance for GEA with that of usual-type endocervical adenocarcinoma (UEA) among patients preoperatively deemed locally early stage (DLES) (< T2b without distant metastasis). Materials and methods For this multi-center retrospective study, 58 patients were enrolled. All had undergone MRI with or without CT and FDG PET-CT preoperatively and had been pathologically diagnosed with GEA at five institutions. Based on the medical charts and radiological reports, the diagnostic performances of preoperative imaging for the International Federation of Gynecology and Obstetrics staging factors were assessed retrospectively. Next, the imaging performance was assessed in preoperatively DLES-GEA (n = 36) and DLES-UEA (n = 136, with the same inclusion criteria). The proportions of underestimation of GEA and UEA were compared using Fisher’s exact test. Results Imaging diagnostic performance for GEA was limited, especially for sensitivity: parametrial invasion, 0.49; vaginal invasion, 0.54; pelvic lymph node metastasis (PELNM), 0.48; para-aortic lymph node metastasis, 0.00; and peritoneal dissemination, 0.25. Among preoperatively DLES patients, the proportions of underestimation were significantly higher in GEA than in UEA; parametrial invasion, 35% vs. 5% (p < 0.01); vaginal invasion, 28% vs. 6% (p < 0.01); PELNM, 24% vs. 6% (p < 0.05); peritoneal dissemination, 6% vs. 0% (p < 0.05). Conclusion At present, preoperative imaging diagnostic performance for staging factors in GEA does not meet clinical expectations, especially for sensitivity. Among patients preoperatively DLES, the proportions of underestimation in GEA were significantly higher than in UEA. Future incorporation of approaches specifically emphasizing GEA is desirable to improve imaging performance.

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Gastric-Type Adenocarcinoma of the Uterine Cervix Associated with Poor Response to Definitive Radiotherapy

Cited by 6 publications

References 36 publications

A case of endocervical adenocarcinoma of the gastric type that was repeatedly misdiagnosed: A case report and literature review

A case of endocervical adenocarcinoma of the gastric type that was repeatedly misdiagnosed: A case report and literature review

Expression of B7‐H3 and TIM‐3 in gastric‐type endocervical adenocarcinoma: prevalence, association with PD‐L1 expression, and prognostic significance

Limited diagnostic performance of imaging evaluation for staging in gastric-type endocervical adenocarcinoma: a multi-center study

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