Ira Winer1, Isabel Alvarado-Cabrero2, Oudai Hassan3, Quratulain F Ahmed3, Baraa Alosh3, Sudeshna Bandyopadhyay3, Sumi Thomas3, Samet Albayrak4, Shobhana Talukdar5, Zaid Al-Wahab1, Mohamed A Elshaikh6, Adnan Munkarah7, Robert Morris1, Rouba Ali-Fehmi8. 1. Department of Oncology, Division of Gynecologic Oncology/Wayne State University/Karmanos Cancer Center, 4160 John R., Suite 721, Detroit, MI 48201, USA. 2. Department of Pathology, Hospital de Oncología, Centro Médico Nacional, IMSS, CMN Siglo XXI, Mexico City, DF 06720, Mexico. 3. Department of Pathology/Wayne State University/Detroit Medical Center, Harper University Hospital, Prof. Bldg., 824-01 Department of Pathology, Detroit, MI 48201, USA. 4. Department of OB/GYN/Wayne State University, Harper University Hospital, 4160 John R., Detroit, MI 48201, USA. 5. Department of OB/GYN/Henry Ford Hospital, 2799 West Grand Boulevard, Detroit, MI 48202, USA. 6. Department of Radiation Oncology/Henry Ford Hospital, 2799 West Grand Boulevard, Detroit, MI 48202, USA. 7. Department of OB/GYN, Division of Gynecologic Oncology/Henry Ford Hospital, 2799 West Grand Boulevard, Detroit, MI 48202, USA. 8. Department of Pathology/Wayne State University/Detroit Medical Center, Harper University Hospital, Prof. Bldg., 824-01 Department of Pathology, Detroit, MI 48201, USA. Electronic address: rali@med.wayne.edu.
Abstract
BACKGROUND: Cervical adenocarcinomas (ADC) have been viewed as more aggressive than squamous cell carcinoma (SCC). We analyzed an international cohort of early stage cervical cancer to determine the impact of histologic type. METHODS: Retrospective analysis of patients with SCC (148 patients) and ADC (130 patients) stages IA1-IB2 who underwent surgery at our three institutions (two from Detroit, one from Mexico) from 2000-2010 was performed for: age, stage, tumor size, lymphovascular invasion (LVI), invasion depth, lymph node status (LN), recurrence and survival. Pathologic review proceeded inclusion. RESULTS: In the Latino population, ADC's tended to be higher grade (p=0.01), while SCC's were larger with deeper invasion (p<0.001). LVI and LN were not significantly different. Recurrence rate (RR) was 8% (8/101) in ADC and 11.8% (9/76) in SCCs. 5 year survival (OS) was equivalent (98.2% and 95.2% for ADC and SCC respectively, p=0.369). In the Detroit cohort, we noted no difference in size, grade, depth of invasion, LVI, LN. RR was 8/72 (13.7%) for SCC and 4/29 (13.7%) but not statistically different between the tumor types (p=0.5). 5 year survival was 91% and 92% for ADC and SCC, respectively. In this population 33% of the patients with SCC and 34% of the patients with ADC received adjuvant chemo-radiation (p=0.4). Histologic type demonstrated no significant outcome difference for any type of adjuvant therapy. CONCLUSION: Comparing early stage disease cervical ADC and SCC suggests equivalent recurrence and survival. Therefore, the paradigm of more aggressive management of early stage cervical ADC warrants further investigation.
BACKGROUND: Cervical adenocarcinomas (ADC) have been viewed as more aggressive than squamous cell carcinoma (SCC). We analyzed an international cohort of early stage cervical cancer to determine the impact of histologic type. METHODS: Retrospective analysis of patients with SCC (148 patients) and ADC (130 patients) stages IA1-IB2 who underwent surgery at our three institutions (two from Detroit, one from Mexico) from 2000-2010 was performed for: age, stage, tumor size, lymphovascular invasion (LVI), invasion depth, lymph node status (LN), recurrence and survival. Pathologic review proceeded inclusion. RESULTS: In the Latino population, ADC's tended to be higher grade (p=0.01), while SCC's were larger with deeper invasion (p<0.001). LVI and LN were not significantly different. Recurrence rate (RR) was 8% (8/101) in ADC and 11.8% (9/76) in SCCs. 5 year survival (OS) was equivalent (98.2% and 95.2% for ADC and SCC respectively, p=0.369). In the Detroit cohort, we noted no difference in size, grade, depth of invasion, LVI, LN. RR was 8/72 (13.7%) for SCC and 4/29 (13.7%) but not statistically different between the tumor types (p=0.5). 5 year survival was 91% and 92% for ADC and SCC, respectively. In this population 33% of the patients with SCC and 34% of the patients with ADC received adjuvant chemo-radiation (p=0.4). Histologic type demonstrated no significant outcome difference for any type of adjuvant therapy. CONCLUSION: Comparing early stage disease cervical ADC and SCC suggests equivalent recurrence and survival. Therefore, the paradigm of more aggressive management of early stage cervical ADC warrants further investigation.
Authors: Joanne K L Rutgers; Andres A Roma; Kay J Park; Richard J Zaino; Abbey Johnson; Isabel Alvarado; Dean Daya; Golnar Rasty; Teri A Longacre; Brigitte M Ronnett; Elvio G Silva Journal: Mod Pathol Date: 2016-06-03 Impact factor: 7.842
Authors: Jeanny Kwon; Keun-Young Eom; Young Seok Kim; Won Park; Mison Chun; Jihae Lee; Yong Bae Kim; Won Sup Yoon; Jin Hee Kim; Jin Hwa Choi; Sei Kyung Chang; Bae Kwon Jeong; Seok Ho Lee; Jihye Cha Journal: Cancer Res Treat Date: 2017-10-24 Impact factor: 4.679