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Oncologic outcomes of patients with FIGO 2014 stage IB-IIA cervical adenocarcinoma who underwent radical surgery

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To identify prognostic factors of early-stage cervical adenocarcinoma in patients with FIGO IB–IIA, who were treated with radical surgery.

Materials and methods

Clinical data of 64 patients with stage IB–IIA cervical adenocarcinoma who underwent radical hysterectomy and lymphadenectomy with or without adjuvant therapy between 1993 and 2019 were retrospectively reviewed. The clinicopathologic factors that affect the oncological outcomes were evaluated. The Kaplan–Meier method was used for the assessment of survival outcomes. Survival curves were compared using the log-rank test.

Results

The 5-year recurrence-free survival and 5-year disease-specific survivals were 83% and 98%, respectively. Tumor size, stage of disease and uterine spread were significantly related prognostic factors for shorter recurrence-free survival. During the follow-up, nine (14.1%) patients recurred. Five of them were extrapelvic recurrence. No correlation was identified between histopathologic subtype and extrapelvic recurrence (p = 0.265). There was no difference between adjuvant only radiotherapy and concurrent chemoradiotherapy on recurrence-free survival in a univariate analysis adjusting for prognostic factors.

Conclusion

It is important to determine the prognostic factors that predict disease outcome in surgically treated cervical adenocarcinoma for tailored adjuvant treatment. Tumor size, stage and uterine spread are determinant factors for recurrence. Risk stratifications, including uterine spread may especially be useful for patients with AC.

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References

  1. The online GLOBOCAN database is accessible at http://gco.iarc.fr/, as part of IARC’s Global Cancer Observatory. 2018. Accessed 17 Mar 2021

  2. Gadducci A, Guerrieri ME, Cosio S (2014) Adenocarcinoma of the uterine cervix: pathologic features, treatment options, clinical outcome and prognostic variables. Crit Rev Oncol Hematol 135:103–114

    Article  Google Scholar 

  3. Gien LT, Beauchemin MC, Thomas G (2010) Adenocarcinoma: a unique cervical cancer. Gynecol Oncol 116(1):140–146

    Article  CAS  Google Scholar 

  4. Stolnicu S, Hoang L, Soslow RA (2019) Recent advances in invasive adenocarcinoma of the cervix. Virchows Arch 475(5):537–549

    Article  Google Scholar 

  5. Vandenbroucke L, Robert A-L, Lavoué V, Foucher F, Henno S, Levêque J (2013) L’adénocarcinome du col utérin: particularités diagnostiques et thérapeutiques. J Gynecol Obstet Biol Reprod 42(3):207–216

    Article  CAS  Google Scholar 

  6. Kim H, Cho WK, Kim YJ, Kim YS, Park W (2020) Significance of the number of high-risk factors in patients with cervical cancer treated with radical hysterectomy and concurrent chemoradiotherapy. Gynecol Oncol 157(2):423–428

    Article  CAS  Google Scholar 

  7. Gülseren V, Kocaer M, Çakır İ, Özdemir İA, Sancı M, Güngördük K (2020) Postoperative nomogram for the prediction of disease-free survival in lymph node-negative stage I-IIA cervical cancer patients treated with radical hysterectomy. J Obstet Gynaecol 40(5):699–704

    Article  Google Scholar 

  8. Singh P, Tripcony L, Nicklin J (2012) Analysis of prognostic variables, development of predictive models, and stratification of risk groups in surgically treated FIGO early-stage (IA-IIA) carcinoma cervix. Int J Gynecol Cancer 22(1):115–122

    Article  Google Scholar 

  9. Kato T, Watari H, Takeda M, Hosaka M, Mitamura T, Kobayashi N, Sudo S, Kaneuchi M, Kudo M, Sakuragi N (2013) Multivariate prognostic analysis of adenocarcinoma of the uterine cervix treated with radical hysterectomy and systematic lymphadenectomy. J Gynecol Oncol 24(3):222–228

    Article  Google Scholar 

  10. Widschwendter P, Janni W, Scholz C, De Gregorio A, De Gregorio N, Friedl TWP (2019) Prognostic factors for and pattern of lymph-node involvement in patients with operable cervical cancer. Arch Gynecol Obstet 300(6):1709–1718

    Article  CAS  Google Scholar 

  11. Abu-Rustum NR, Yashar CM, Bean S, Bradley K, Campos SM, Chon HS, Chu C, Cohn D, Crispens MA, Damast S, Fisher CM, Frederick P, Gaffney DK, Giuntoli R, Han E, Huh WK, Lurain Iii JR, Mariani A, Mutch D, Nagel C, Nekhlyudov L, Fader AN, Remmenga SW, Reynolds RK, Sisodia R, Tillmanns T, Ueda S, Urban R, Wyse E, McMillian NR, Motter AD (2020) NCCN guidelines insights: cervical cancer, version 1.2020. J Natl Compr Canc Netw 18(6):660–666

    Article  Google Scholar 

  12. Park JY, Kim DY, Kim JH, Kim YM, Kim YT, Nam JH (2010) Outcomes after radical hysterectomy in patients with early-stage adenocarcinoma of uterine cervix. British J Cancer 102:1692–1698

    Article  CAS  Google Scholar 

  13. Galic V, Herzog TJ, Lewin SN, Neugut AI, Burke WM, Lu YS, Hershman DL, Wright JD (2012) Prognostic significance of adenocarcinoma histology in women with cervical cancer. Gynecol Oncol 125(2):287–291

    Article  Google Scholar 

  14. Cao L, Wen H, Feng Z, Han X, Wu X (2019) Distinctive clinicopathologic characteristics and prognosis for different histologic subtypes of early cervical cancer. Int J Gynecol Cancer 29(8):1244–1251

    Article  Google Scholar 

  15. Zhou J, Zhang WW, Wu SG, He ZY, Sun JY, Yang GF, Li FY (2017) The prognostic value of histologic subtype in node-positive early-stage cervical cancer after hysterectomy and adjuvant radiotherapy. Int J Surg 44:1–6

    Article  CAS  Google Scholar 

  16. Aslan K, Haberal A, Akıllı H, Meydanli MM, Ayhan A (2021) Prognostic value of the number of the metastatic lymph nodes in locally early-stage cervical cancer: squamous cell carcinoma versus non-squamous cell carcinoma. Arch Gynecol Obstet 304(5):1279–1289

    Article  Google Scholar 

  17. Roma AA, Fadare O (2018) The pattern is the issue: recent advances in adenocarcinoma of the uterine cervix. Virchows Arch 472(6):897–905

    Article  CAS  Google Scholar 

  18. Kurman RJ, Carcangiu ML, Herrington CS, Young RH (eds) (2014) WHO classification of tumours of female reproductive organs, 4th edn. Lyon, International Agency for Research on Cancer

    Google Scholar 

  19. Mabuchi S, Okazawa M, Kinose Y, Matsuo K, Fujiwara M, Suzuki O, Morii E, Kamiura S, Ogawa K, Kimura T (2012) Comparison of the prognoses of FIGO stage I to stage II adenosquamous carcinoma and adenocarcinoma of the uterine cervix treated with radical hysterectomy. Int J Gynecol Cancer 22(8):1389–1397

    Article  Google Scholar 

  20. Mabuchi Y, Yahata T, Kobayashi A, Tanizaki Y, Shiro M, Ota N, Yagi S, Minami S, Ino K (2015) Clinicopathologic factors of cervical adenocarcinoma stages IB to IIB. Int J Gynecol Cancer 25(9):1677–1682

    Article  Google Scholar 

  21. Kasamatsu T, Onda T, Sawada M, Kato T, Ikeda S, Sasajima Y, Tsuda H (2009) Radical hysterectomy for FIGO stage I-IIB adenocarcinoma of the uterine cervix. British J Cancer 100(9):1400–1405

    Article  CAS  Google Scholar 

  22. Baek MH, Park JY, Kim D, Suh D-S, Kim J-H, Kim Y-M, Kim Y-T, Nam J-H (2014) Comparison of adenocarcinoma and adenosquamous carcinoma in patients with early-stage cervical cancer after radical surgery. Gynecol Oncol 135(3):462–467

    Article  Google Scholar 

  23. Chargui R, Damak T, Khomsi F, Hassouna JB, Chaieb W, Hechiche M, Gamaudi A, Boussen H, Benna F, Rahal K (2006) Prognostic factors and clinicopathologic characteristics of invasive adenocarcinoma of the uterine cervix. Am J Obstet Gynecol 194(1):43–48

    Article  Google Scholar 

  24. Matsuo K, Machida H, Blake EA, Takiuchi T, Mikami M, Roman LD (2017) Significance of uterine corpus tumor invasion in early-stage cervical cancer. Eur J Surg Oncol 43(4):725–734

    Article  CAS  Google Scholar 

  25. He F, Li W, Liu P, Kang S, Sun L, Zhao H, Chen X, Yin L, Wang L, Chen J, Fan H, Li P, Yang H, Wang F, Chen C (2020) Influence of uterine corpus invasion on prognosis in stage IA2-IIB cervical cancer: A multicenter retrospective cohort study. Gynecol Oncol 158(2):273–281

    Article  Google Scholar 

  26. Li W, He F, Liu P, Duan H, Ni Y, Wang S, Lin L, Yin Z, Chen X, Yin L, Wang L, Liu Y, Luan Z, Chen C (2021) Uterine corpus invasion in cervical cancer: a multicenter retrospective case-control study. Arch Gynecol Obstet 303(3):777–785

    Article  Google Scholar 

  27. Jung EJ, Byun JM, Kim YN, Lee KB, Sung MS, Kim KT, Jeong DH (2017) Cervical adenocarcinoma has a poorer prognosis and a higher propensity for distant recurrence than squamous cell carcinoma. Int J Gynecol Cancer 27(6):1228–1236

    Article  Google Scholar 

  28. Lee YY, Choi CH, Kim TJ, Lee JW, Kim BG, Lee JH, Bae DS (2011) A comparison of pure adenocarcinoma and squamous cell carcinoma of the cervix after radical hysterectomy in stage IB-IIA. Gynecol Oncol 120(3):439–443

    Article  Google Scholar 

  29. Scharl S, Becher C, Gerken M, Scharl A, Anapolski M, Ignatov A, Inwald EC, Ortmann O, Kölbl O, Klinkhammer-Schalke M, Papathemelis T (2021) Is there a benefit for adjuvant radio(chemo)therapy in early cervical cancer? Results from a population-based study. Arch Gynecol Obstet 304(3):759–771

    Article  Google Scholar 

  30. Landoni F, Maneo A, Zapardiel I, Zanagnolo V, Mangioni C (2012) Class I versus class III radical hysterectomy in stage IB1-IIA cervical cancer. A prospective randomized study. Eur J Surg Oncol 38(3):203–209

    Article  CAS  Google Scholar 

  31. Huang YT, Wang CC, Tsai CS, Lai CH, Chang TC, Chou HH, Lee SP, Hong JH (2012) Clinical behaviours and outcomes for adenocarcinoma or adenosquamous carcinoma of cervix treated by radical hysterectomy and adjuvant radiotherapy or chemoradiotherapy. Int J Radiat Oncol Biol Phys 84(2):420–427

    Article  Google Scholar 

  32. Seki T, Tanabe H, Nagata C, Suzuki J, Suzuki K, Takanao H, Isonishi S, Ochiai K, Takakura S, Okamoto A (2017) Adjuvant therapy after radical surgery for stage IB-IIB cervical adenocarcinoma with risk factors. Jpn J Clin Oncol 47(1):32–38

    Article  Google Scholar 

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Funding

None to declare.

Author information

Authors and Affiliations

  1. Gynecologic Oncology Department, Health Sciences University Etlik Zubeyde Hanim Women’s Health Teaching and Research Hospital, Etlik Street, 06010, Ankara, Turkey

    Dilek Yüksel, Caner Çakır, Çiğdem Kılıç, Günsu Kimyon Cömert, Vakkas Korkmaz, Osman Türkmen & Taner Turan

  2. Gynecology and Obstetrics Department, Health Sciences University Etlik Zubeyde Hanim Women’s Health Teaching and Research Hospital, Ankara, Turkey

    Fatih Kılıç & Mehmet Ünsal

Authors
  1. Dilek Yüksel
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  2. Caner Çakır
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  3. Fatih Kılıç
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  4. Mehmet Ünsal
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  5. Çiğdem Kılıç
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  6. Günsu Kimyon Cömert
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  7. Vakkas Korkmaz
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  8. Osman Türkmen
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  9. Taner Turan
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Contributions

YD: project development, data collection, manuscript writing/editing,surgical and medical practices; CC: data collection or processing, surgical and medical practices; KF: data collection, literature search; UM: data collection, literature search; KC: data collection, literature search, surgical and medical practices; KCG: analysis and interpretation, surgical and medical practices; KV: analysis and interpretation,literature search, surgical and medical practices; TO: surgical and medical practices, analysis and interpretation; TT: project development, surgical and medical practices, analysis and interpretation.

Corresponding author

Correspondence to Dilek Yüksel.

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Conflict of interest

The authors declare that there is no conflict of interest.

Ethical approval

Local Committee of Ethics of Etlik Zubeyde Hanim Women’s Health Care, Training and Research Hospital, University of Health Sciences approved the study with the number of 11/2019.

Informed consent

Written informed consent was obtained from all patients on admission for medical information to be used anonymously for academic purposes.

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Yüksel, D., Çakır, C., Kılıç, F. et al. Oncologic outcomes of patients with FIGO 2014 stage IB-IIA cervical adenocarcinoma who underwent radical surgery. Arch Gynecol Obstet 306, 1657–1664 (2022). https://doi.org/10.1007/s00404-022-06507-2

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  • DOI: https://doi.org/10.1007/s00404-022-06507-2

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