Jae Myoung Noh1, Won Park2, Young Seok Kim3, Joo-Young Kim4, Hak Jae Kim5, Juree Kim6, Jin Hee Kim7, Mee Sun Yoon8, Jin Hwa Choi9, Won Sup Yoon10, Ji-Yoon Kim11, Seung Jae Huh1. 1. Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-gu, Seoul 135-710, Republic of Korea. 2. Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-gu, Seoul 135-710, Republic of Korea. Electronic address: wonro.park@samsung.com. 3. Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Republic of Korea. 4. Proton Therapy Center, Research Institute and Hospital, National Cancer Center, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, Republic of Korea. 5. Department of Radiation Oncology, Seoul National University College of Medicine, 103, Daehak-ro, Jongno-gu, Seoul 110-799, Republic of Korea. 6. Department of Radiation Oncology, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine, 17, Seoae-ro 1-gil, Jung-gu, Seoul 100-380, Republic of Korea. 7. Department of Radiation Oncology, Dongsan Medical Center, Keimyung University School of Medicine, 56, Dalseong-ro, Jung-gu, Daegu 700-712, Republic of Korea. 8. Department of Radiation Oncology, Chonnam National University Medical School, 322, Seoyang-ro, Hwasun-eup, Hwasun-gun, Jeollanam-do 519-763, Republic of Korea. 9. Department of Radiation Oncology, College of Medicine, Chung-Ang University, 102, Heukseok-ro, Dongjak-gu, Seoul 156-755, Republic of Korea. 10. Department of Radiation Oncology, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do 425-807, Republic of Korea. 11. Department of Radiation Oncology, Yeoeuido St. Mary's Hospital, The Catholic University of Korea College of Medicine, 10, 63-ro, Yeongdeungpo-gu, Seoul 150-713, Republic of Korea.
Abstract
OBJECTIVE: To evaluate the prognostic influence of adenocarcinoma (AC) and adenosquamous carcinoma (ASC) in patients with FIGO stage IB-IIA cervical cancer who received radical hysterectomy followed by adjuvant radiotherapy (RT) or concurrent chemoradiotherapy (CCRT). METHODS: We analyzed 1323 patients who satisfied the following criteria: histologically proven squamous cell carcinoma (SCC), AC, or ASC of the uterine cervix; FIGO stage IB-IIA disease; no history of neoadjuvant chemotherapy; and a history of radical hysterectomy with pelvic lymph node (PLN) dissection, followed by postoperative pelvic RT at a dose ≥ 45 Gy. The median age was 50 years. Median RT dose delivered to the whole pelvis was 50.4 Gy, and 219 (16.6%) patients received brachytherapy at a median dose of 24 Gy. Concurrent chemotherapy was delivered to 492 (37.2%) patients. RESULTS: Pathologic risk factors were not different according to pathologic subtype. The median follow-up duration was 75.7 months. Locoregional recurrence-free survival, relapse-free survival (RFS), and overall survival were significantly affected by histology, tumor size, PLN metastasis, parametrial invasion, lymphovascular invasion, and deep stromal invasion. The 5-year RFS rates were 83.7%, 66.5%, and 79.6% in patients with SCC, AC, and ASC histology, respectively (P<0.0001). By multivariate analysis, AC histology was the only significant prognostic factor affecting all survival outcomes. CONCLUSIONS: AC histology was associated with poor survival outcomes in patients with FIGO stage IB-IIA cervical cancer who received adjuvant RT or CCRT. Prognosis of ASC histology was closer to that of SCC histology than that of AC histology.
OBJECTIVE: To evaluate the prognostic influence of adenocarcinoma (AC) and adenosquamous carcinoma (ASC) in patients with FIGO stage IB-IIA cervical cancer who received radical hysterectomy followed by adjuvant radiotherapy (RT) or concurrent chemoradiotherapy (CCRT). METHODS: We analyzed 1323 patients who satisfied the following criteria: histologically proven squamous cell carcinoma (SCC), AC, or ASC of the uterine cervix; FIGO stage IB-IIA disease; no history of neoadjuvant chemotherapy; and a history of radical hysterectomy with pelvic lymph node (PLN) dissection, followed by postoperative pelvic RT at a dose ≥ 45 Gy. The median age was 50 years. Median RT dose delivered to the whole pelvis was 50.4 Gy, and 219 (16.6%) patients received brachytherapy at a median dose of 24 Gy. Concurrent chemotherapy was delivered to 492 (37.2%) patients. RESULTS: Pathologic risk factors were not different according to pathologic subtype. The median follow-up duration was 75.7 months. Locoregional recurrence-free survival, relapse-free survival (RFS), and overall survival were significantly affected by histology, tumor size, PLN metastasis, parametrial invasion, lymphovascular invasion, and deep stromal invasion. The 5-year RFS rates were 83.7%, 66.5%, and 79.6% in patients with SCC, AC, and ASC histology, respectively (P<0.0001). By multivariate analysis, AC histology was the only significant prognostic factor affecting all survival outcomes. CONCLUSIONS: AC histology was associated with poor survival outcomes in patients with FIGO stage IB-IIA cervical cancer who received adjuvant RT or CCRT. Prognosis of ASC histology was closer to that of SCC histology than that of AC histology.
Authors: Tanja Fehm; Frederik A Stübs; Martin C Koch; Peter Mallmann; Christian Dannecker; Anna Dietl; Anna Sevnina; Franziska Mergel; Laura Lotz; Anne Ehret; Daniel Gantert; Franca Martignoni; Jan-Philipp Cieslik; Jan Menke; Olaf Ortmann; Carmen Stromberger; Karin Oechsle; Beate Hornemann; Friederike Mumm; Christoph Grimm; Alina Sturdza; Edward Wight; Kristina Loessl; Michael Golatta; Volker Hagen; Timm Dauelsberg; Ingo Diel; Karsten Münstedt; Eberhard Merz; Dirk Vordermark; Katja Lindel; Christian Wittekind; Volkmar Küppers; Ralph Lellé; Klaus Neis; Henrik Griesser; Birgit Pöschel; Manfred Steiner; Ulrich Freitag; Tobias Gilster; Alexander Schmittel; Michael Friedrich; Heidemarie Haase; Marion Gebhardt; Ludwig Kiesel; Michael Reinhardt; Michael Kreißl; Marianne Kloke; Lars-Christian Horn; Regina Wiedemann; Simone Marnitz; Anne Letsch; Isabella Zraik; Bernhard Mangold; Jochen Möckel; Céline Alt; Pauline Wimberger; Peter Hillemanns; Kerstin Paradies; Alexander Mustea; Dominik Denschlag; Ulla Henscher; Reina Tholen; Simone Wesselmann; Matthias W Beckmann Journal: Geburtshilfe Frauenheilkd Date: 2022-02-11 Impact factor: 2.915
Authors: Nalee Kim; Won Park; Won Kyung Cho; Duk-Soo Bae; Byoung-Gie Kim; Jeong-Won Lee; Tae-Joong Kim; Chel Hun Choi; Yoo-Young Lee; Young Seok Cho Journal: Cancer Res Treat Date: 2020-12-09 Impact factor: 4.679