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Comparative Study
. 2014 Nov;135(2):208-12.
doi: 10.1016/j.ygyno.2014.08.018. Epub 2014 Aug 23.

Locally advanced adenocarcinoma and adenosquamous carcinomas of the cervix compared to squamous cell carcinomas of the cervix in gynecologic oncology group trials of cisplatin-based chemoradiation

Peter G Rose  1 , James J Java  2 , Charles W Whitney  3 , Frederick B Stehman  4 , Rachelle Lanciano  5 , Gillian M Thomas  6
Affiliations
Comparative Study

Locally advanced adenocarcinoma and adenosquamous carcinomas of the cervix compared to squamous cell carcinomas of the cervix in gynecologic oncology group trials of cisplatin-based chemoradiation

Peter G Rose et al. Gynecol Oncol. 2014 Nov.

Abstract

Objective: Conflicting results have been reported for adeno- and adenosquamous carcinomas of the cervix with respect to their response to therapy and prognosis. The current study sought to evaluate impact of adeno- and adenosquamous histology in the randomized trials of primary cisplatin-based chemoradiation for locally advanced cervical cancer.

Methods: Patients with adeno- and adenosquamous cervical carcinomas were retrospectively studied and compared to squamous cell carcinomas in GOG trials of chemoradiation.

Results: Among 1671 enrolled in clinical trials of chemoradiation, 182 adeno- and adenosquamous carcinomas were identified (10.9%). A higher percentage of adeno- and adenosquamous carcinomas were stage IB2 (27.5% versus 20.0%) and fewer had stage IIIB (21.4% versus 28.6%). The mean tumor size was larger for squamous than adeno- and adenosquamous. Adeno- and adenosquamous carcinomas were more often poorly differentiated (46.2% versus 26.8%). When treated with radiation therapy alone, the 70 patients with adeno- and adenosquamous carcinoma of the cervix showed a statistically poorer overall survival (p=0.0499) compared to the 647 patients with squamous cell carcinoma of the cervix. However, when treated with radiation therapy with concurrent cisplatin-based chemotherapy, the 112 patients with adeno- and adenosquamous carcinomas had a similar overall survival (p=0.459) compared the 842 patients with squamous cell carcinoma. Adverse effects to treatment were similar across histologies.

Conclusion: Adeno- and adenosquamous carcinomas of the cervix are associated with worse overall survival when treated with radiation alone but with similar progression-free and overall survival compared to squamous cell carcinomas of the cervix when treated with cisplatin based chemoradiation.

Keywords: Adenocarcinoma; Adenosquamous carcinoma; Cervix; Cisplatin-based chemoradiation; GOG.

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Conflict of interest statement

Conflict of Interest

The authors wish to disclose that there are no conflicts of interest.

Figures

Figure 1
Figure 1
Overall survival for patients with squamous and adeno- and adenosquamous carcinomas treated with radiation alone
Figure 2
Figure 2
Overall survival for patients with squamous and adeno- and adenosquamous carcinomas treated with radiation and concurrent cisplatin chemotherapy
See this image and copyright information in PMC

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