The prognostic value of histologic subtype in node-positive early-stage cervical cancer after hysterectomy and adjuvant radiotherapy

INTERNATIONAL JOURNAL OF SURGERY

卷:44

Article

Zhou, Juan¹  Zhang, Wen-Wen²  Wu, San-Gang³  He, Zhen-Yu²  Sun, Jia-Yuan²  Yang, Guo-Fen⁴  Li, Feng-Yan² 

[1] Xiamen Univ, Dept Obstet & Gynecol, Affiliated Hosp 1, Xiamen 361003, Peoples R China

[2] Sun Yat Sen Univ, Dept Radiat Oncol, Collaborat Innovat Ctr Canc Med, State Key Lab Oncol South China,Canc Ctr, Guangzhou 510060, Guangdong, Peoples R China

[3] Xiamen Univ, Affiliated Hosp 1, Xiamen Canc Hosp, Dept Radiat Oncol, Xiamen 361003, Peoples R China

[4] Sun Yat Sen Univ, Affiliated Hosp 1, Dept Gynecol, Guangzhou 510080, Guangdong, Peoples R China

关键词: Cervical cancer;    Squamous cell carcinoma;    Adenocarcinoma;    Radiotherapy;    Survival;   

DOI  :  10.1016/j.ijsu.2017.05.074

来源: Elsevier

【 摘 要 】

Background: To assess the survival outcomes in patients with International Federation of Gynecology and Obstetrics (FIGO) stage I-IIA adenocarcinoma (AC) or squamous cell carcinoma (SCC) of the uterine cervix after hysterectomy and adjuvant radiotherapy (RT). Methods: Patients with a primary diagnosis of FIGO stage I-IIA AC or SCC of the uterine cervix after hysterectomy and adjuvant RT between 1988 and 2012 were included using data from the Surveillance, Epidemiology, and End Results database. Univariate and multivariate Cox regression analyses were used to analyze the effect of histologic subtype on cause-specific survival (CSS) and overall survival (OS). Results: We included 1171 patients: 919 with cervical SCC and 252 with cervical AC. In multivariate analysis, cervical AC was an independent adverse prognostic factor for survival. Patients with cervical AC had worse CSS (p = 0.001) and OS (p = 0.001) compared to patients with cervical SCC. In the subgroup analysis, patients with cervical SCC in the era of concurrent chemoradiotherapy (CCRT) (2000-2012) had better CSS (p = 0.006) and OS (p = 0.004) compared with the era of RT. However, there was no significant difference in CSS (p = 0.079) and OS (p = 0.053) between the eras of RT (1988-1999) and CCRT for patients with cervical AC. Conclusions: Survival of cervical AC is significantly worse than that of cervical SCC. As CCRT usage increases, the survival benefit is derived only in cervical SCC, but not in cervical AC. (C) 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

【 授权许可】

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