Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 135-710, Republic of Korea.
Gynecol Oncol. 2011 Mar;120(3):439-43. doi: 10.1016/j.ygyno.2010.11.022. Epub 2010 Dec 8.
This study was designed to investigate the survival difference between pure adenocarcinoma (AC) and squamous cell carcinoma (SCC) in early cervical cancer (FIGO stage IB-IIA) after radical hysterectomy with or without adjuvant therapy performed at a single institution.
Patients with AC or SCC between November 1994 and September 2007 at the Samsung Medical Center, Sungkyunkwan University School of Medicine in Seoul, Korea were evaluated.
Among the 775 patients, 636 patients had SCC, and 139 patients had pure AC. In basal characteristics, preoperative FIGO stage, adjuvant therapy after surgery, as well as chemotherapeutic regimens, were not different between the two groups. However, the median age was about 5 years younger in pure AC patients than in SCC patients (44 years vs. 49 years, P=.001). In the comparison of pathological findings after surgery between the two groups, there were no differences between the two groups, except for LVSI status. The recurrence rate was higher in the pure AC group than in the SCC group (SCC; 36/636; 5.7%, AC; 20/139; 14.4%, P=<0.001, respectively). The pure AC group had a higher recurrence rate in hematogenous/distant areas than the SCC group (SCC: 8/36; 22.2%, AC; 9/20; 45.0%, P=.076, respectively). In multivariable analysis, positive for pelvic LN and the pure AC cell type were independent factors in both DFS and OS.
We observed that pure AC of the cervix might entail a worse survival outcome than SCC in patients with early cervical cancer (IB-IIA).
本研究旨在探讨在单一机构行根治性子宫切除术及辅助治疗后，FIGO 分期 IB-IIA 期的早期宫颈癌中，纯腺癌（AC）与鳞癌（SCC）患者的生存差异。
评估韩国首尔延世大学三星医疗中心 1994 年 11 月至 2007 年 9 月期间的 AC 或 SCC 患者。
在 775 例患者中，636 例为 SCC，139 例为纯 AC。在基线特征、术前 FIGO 分期、术后辅助治疗以及化疗方案方面，两组之间没有差异。然而，纯 AC 患者的中位年龄比 SCC 患者年轻约 5 岁（44 岁比 49 岁，P=.001）。在两组术后病理检查结果的比较中，除 LVSI 状态外，两组之间无差异。纯 AC 组的复发率高于 SCC 组（SCC：36/636；5.7%，AC：20/139；14.4%，P<.001）。纯 AC 组在血行/远处转移区域的复发率高于 SCC 组（SCC：8/36；22.2%，AC：9/20；45.0%，P=.076）。多变量分析显示，盆腔淋巴结阳性和纯 AC 细胞类型是 DFS 和 OS 的独立因素。
我们观察到，在早期宫颈癌（IB-IIA）患者中，宫颈纯 AC 可能比 SCC 预后更差。
