Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Mar;160(3):993-1000.
doi: 10.1002/ijgo.14442. Epub 2022 Sep 21.

Prognosis determination of endocervical adenocarcinomas morphologically reclassified as HPV associated or HPV independent

Carla Fabrine Carvalho  1 , Larissa Bastos Eloy Costa  2 , Natasha Caroline Sanches  1 , Ingrid Iara Damas  2 , Liliana Aparecida Lucci De Angelo Andrade  2 , Diama Bhadra Vale  1
Affiliations

Prognosis determination of endocervical adenocarcinomas morphologically reclassified as HPV associated or HPV independent

Carla Fabrine Carvalho et al. Int J Gynaecol Obstet. 2023 Mar.

Abstract

Objective: To evaluate the prognosis of endocervical adenocarcinomas after reclassification according to the morphologic type based on the 2020 World Health Organization Classification.

Methods: A retrospective longitudinal study with cases admitted at the University of Campinas, Brazil, from 2013 to 2020. The sample included 140 cases morphologically reclassified: 100 cases as adenocarcinoma HPV-associated (HPVA), 17 as HPV-independent (HPVI), and 23 non-HPVA/HPVI. Clinic and pathologic variables were evaluated. Analyses were performed by χ2 , Fisher exact, and Mann-Whitney U tests, Kaplan-Meier curves, Log-rank test, and Cox regression.

Results: Compared with the HPVA group, advanced stage (FIGO Stage II+) was more frequent in the HPVI group (P = 0.009), which also showed older patients (P = 0.032), and a higher proportion of deaths (P = 0.006). The median overall survival (OS) differed between groups: 73.3 months in HPVA and 42.4 months in HPVI (P = 0.005). At the multivariate analysis, the risk of death was 6.7 (95% confidence interval 1.9-23.0) times higher in patients diagnosed in advanced stages.

Conclusion: HPVI cases were more frequent in older patients, presenting at more advanced stages and with worse OS. The morphology-based approach of the new WHO classification appears to be prognostically valuable and applicable in lower- and middle-income settings.

Keywords: International Endocervical Adenocarcinoma Criteria and Classification; adenocarcinoma; clinical outcomes; human papillomavirus; neoplasms by histologic type; prognosis; uterine cervical neoplasms.

PubMed Disclaimer

References

REFERENCES

    1. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71:209-249.
    1. Small W Jr, Bacon MA, Bajaj A, et al. Cervical cancer: a global health crisis. Cancer. 2017;123:2404-2412.
    1. Nogueira-Rodrigues A, Ferreira CG, Bergmann A, de Aguiar SS, Thuler LCS. Comparison of adenocarcinoma (ACA) and squamous cell carcinoma (SCC) of the uterine cervix in a sub-optimally screened cohort: a population-based epidemiologic study of 51,842 women in Brazil. Gynecol Oncol. 2014;135:292-296.
    1. Bhatla N, Aoki D, Sharma DN, Sankaranarayanan R. Cancer of the cervix uteri. Int J Gynaecol Obstet. 2018;143(Suppl 2):22-36.
    1. Jung EJ, Byun JM, Kim YN, et al. Cervical adenocarcinoma has a poorer prognosis and a higher propensity for distant recurrence than squamous cell carcinoma. Int J Gynecol Cancer. 2017;27:1228-1236.