Comparison of Survival Outcomes in Early Stage Invasive Adenocarcinoma with Squamous Cell Carcinoma of the Uterine Cervix
Marut Yanaranop MD*,***, Suphet Tuipae MD*,***, Saranyu Nakrangsee MD**,***
Affiliation : * Department of Obstetrics and Gynecology, Rajavithi Hospital, Bangkok, Thailand. ** Department of Pathology, Rajavithi Hospital,Bangkok, Thailand *** College of Medicine, Rangsit University, Bangkok, Thailand
Background : Invasive adenocarcinoma (AC) is the second most common carcinoma of the uterine cervix; however, it is not
clear whether this histologic type influences survival outcomes.
Objective : To evaluate the survival outcomes of patients with invasive AC compared to those with squamous cell carcinoma
(SCC) in early stage cervical cancer following radical hysterectomy.
Material and Method: A historical cohort study was conducted of 316 Thai women with cervical cancer clinical stage IA2-
IIA (120 AC and 196 SCC) who underwent radical hysterectomy from January 1 to December 31, 2000.
Results : With a median follow-up of 65.23 months, the estimated 5-year recurrence-free survival (RFS) and overall survival
(OS) for patients with AC did not significantly differ from those with SCC (90.3% vs. 93.1%, p = 0.301 and 90.9% vs. 93.5%,
p = 0.342 respectively). Using Cox regression analysis, cervical stroma invasion (CSI) and lymphovascular space invasion
(LVSI) were the significant prognostic factors for RFS, whereas CSI was the only significant prognostic factor for OS. Women
with AC who had two prognostic factors showed significantly lower 5-year RFS than those with SCC (69.5% vs. 86.3%,
p = 0.035).
Conclusion : Survival and recurrence were not different for surgically treated cervical cancer in women with early stage AC
or SCC.
Keywords : Cervical cancer, Adenocarcinoma, Squamous cell carcinoma, Radical hysterectomy, Survival
