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Clinical behaviors and outcomes for adenocarcinoma or adenosquamous carcinoma of cervix treated by radical hysterectomy and adjuvant radiotherapy or chemoradiotherapy.
Int J Radiat Oncol Biol Phys. 2012 Oct 01; 84(2):420-7.IJ

Abstract

PURPOSE

To compare clinical behaviors and treatment outcomes between patients with squamous cell carcinoma (SCC) and adenocarcinoma/adenosquamous carcinoma (AC/ASC) of the cervix treated with radical hysterectomy (RH) and adjuvant radiotherapy (RT) or concurrent chemoradiotherapy (CCRT).

METHODS AND MATERIALS

A total of 318 Stage IB-IIB cervical cancer patients, 202 (63.5%) with SCC and 116 (36.5%) with AC/ASC, treated by RH and adjuvant RT/CCRT, were included. The indications for RT/CCRT were deep stromal invasion, positive resection margin, parametrial invasion, or lymph node (LN) metastasis. Postoperative CCRT was administered in 65 SCC patients (32%) and 80 AC/ASC patients (69%). Patients with presence of parametrial invasion or LN metastasis were stratified into a high-risk group, and the rest into an intermediate-risk group. The patterns of failure and factors influencing survival were evaluated.

RESULTS

The treatment failed in 39 SCC patients (19.3%) and 39 AC/ASC patients (33.6%). The 5-year relapse-free survival rates for SCC and AC/ASC patients were 83.4% and 66.5%, respectively (p = 0.000). Distant metastasis was the major failure pattern in both groups. After multivariate analysis, prognostic factors for local recurrence included younger age, parametrial invasion, AC/ASC histology, and positive resection margin; for distant recurrence they included parametrial invasion, LN metastasis, and AC/ASC histology. Compared with SCC patients, those with AC/ASC had higher local relapse rates for the intermediate-risk group but a higher distant metastasis rate for the high-risk group. Postoperative CCRT tended to improve survival for intermediate-risk but not for high-risk AC/ASC patients.

CONCLUSIONS

Adenocarcinoma/adenosquamous carcinoma is an independent prognostic factor for cervical cancer patients treated by RH and postoperative RT. Concurrent chemoradiotherapy could improve survival for intermediate-risk, but not necessarily high-risk, AC/ASC patients.

Authors+Show Affiliations

Department of Radiation Oncology, Chang Gung Memorial Hospital, Lin-Kou, Chang Gung University, Taoyuan, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22365621

Citation

Huang, Yi-Ting, et al. "Clinical Behaviors and Outcomes for Adenocarcinoma or Adenosquamous Carcinoma of Cervix Treated By Radical Hysterectomy and Adjuvant Radiotherapy or Chemoradiotherapy." International Journal of Radiation Oncology, Biology, Physics, vol. 84, no. 2, 2012, pp. 420-7.
Huang YT, Wang CC, Tsai CS, et al. Clinical behaviors and outcomes for adenocarcinoma or adenosquamous carcinoma of cervix treated by radical hysterectomy and adjuvant radiotherapy or chemoradiotherapy. Int J Radiat Oncol Biol Phys. 2012;84(2):420-7.
Huang, Y. T., Wang, C. C., Tsai, C. S., Lai, C. H., Chang, T. C., Chou, H. H., Lee, S. P., & Hong, J. H. (2012). Clinical behaviors and outcomes for adenocarcinoma or adenosquamous carcinoma of cervix treated by radical hysterectomy and adjuvant radiotherapy or chemoradiotherapy. International Journal of Radiation Oncology, Biology, Physics, 84(2), 420-7. https://doi.org/10.1016/j.ijrobp.2011.12.013
Huang YT, et al. Clinical Behaviors and Outcomes for Adenocarcinoma or Adenosquamous Carcinoma of Cervix Treated By Radical Hysterectomy and Adjuvant Radiotherapy or Chemoradiotherapy. Int J Radiat Oncol Biol Phys. 2012 Oct 1;84(2):420-7. PubMed PMID: 22365621.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical behaviors and outcomes for adenocarcinoma or adenosquamous carcinoma of cervix treated by radical hysterectomy and adjuvant radiotherapy or chemoradiotherapy. AU - Huang,Yi-Ting, AU - Wang,Chun-Chieh, AU - Tsai,Chien-Sheng, AU - Lai,Chyong-Huey, AU - Chang,Ting-Chang, AU - Chou,Hung-Hsueh, AU - Lee,Steve P, AU - Hong,Ji-Hong, Y1 - 2012/02/24/ PY - 2011/07/28/received PY - 2011/11/09/revised PY - 2011/12/01/accepted PY - 2012/2/28/entrez PY - 2012/3/1/pubmed PY - 2012/11/14/medline SP - 420 EP - 7 JF - International journal of radiation oncology, biology, physics JO - Int. J. Radiat. Oncol. Biol. Phys. VL - 84 IS - 2 N2 - PURPOSE: To compare clinical behaviors and treatment outcomes between patients with squamous cell carcinoma (SCC) and adenocarcinoma/adenosquamous carcinoma (AC/ASC) of the cervix treated with radical hysterectomy (RH) and adjuvant radiotherapy (RT) or concurrent chemoradiotherapy (CCRT). METHODS AND MATERIALS: A total of 318 Stage IB-IIB cervical cancer patients, 202 (63.5%) with SCC and 116 (36.5%) with AC/ASC, treated by RH and adjuvant RT/CCRT, were included. The indications for RT/CCRT were deep stromal invasion, positive resection margin, parametrial invasion, or lymph node (LN) metastasis. Postoperative CCRT was administered in 65 SCC patients (32%) and 80 AC/ASC patients (69%). Patients with presence of parametrial invasion or LN metastasis were stratified into a high-risk group, and the rest into an intermediate-risk group. The patterns of failure and factors influencing survival were evaluated. RESULTS: The treatment failed in 39 SCC patients (19.3%) and 39 AC/ASC patients (33.6%). The 5-year relapse-free survival rates for SCC and AC/ASC patients were 83.4% and 66.5%, respectively (p = 0.000). Distant metastasis was the major failure pattern in both groups. After multivariate analysis, prognostic factors for local recurrence included younger age, parametrial invasion, AC/ASC histology, and positive resection margin; for distant recurrence they included parametrial invasion, LN metastasis, and AC/ASC histology. Compared with SCC patients, those with AC/ASC had higher local relapse rates for the intermediate-risk group but a higher distant metastasis rate for the high-risk group. Postoperative CCRT tended to improve survival for intermediate-risk but not for high-risk AC/ASC patients. CONCLUSIONS: Adenocarcinoma/adenosquamous carcinoma is an independent prognostic factor for cervical cancer patients treated by RH and postoperative RT. Concurrent chemoradiotherapy could improve survival for intermediate-risk, but not necessarily high-risk, AC/ASC patients. SN - 1879-355X UR - https://www.unboundmedicine.com/medline/citation/22365621/Clinical_behaviors_and_outcomes_for_adenocarcinoma_or_adenosquamous_carcinoma_of_cervix_treated_by_radical_hysterectomy_and_adjuvant_radiotherapy_or_chemoradiotherapy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0360-3016(11)03668-6 DB - PRIME DP - Unbound Medicine ER -