Adenocarcinoma of the uterine cervix: why is it different?

Adenocarcinoma (AC) of the uterine cervix is the second most frequent tumor type following squamous cell carcinoma (SCC). According to the National Comprehensive Cancer Network (NCCN) guidelines, there is no difference in the treatment strategy between SCC and AC. However, there are a number of studies that suggest a worse prognosis for AC compared to SCC. In this comprehensive review, we will try to find the reason why AC is different from SCC, and then discuss what we need to do to improve the prognosis of AC. Uterine cervical AC is clearly different from SCC based on its molecular pathogenesis, histological appearance, and clinical behavior. Therefore, it will be necessary to make a different treatment strategy, particularly for patients with locally advanced and metastatic or recurrent disease. It is most important to intensify our research into the molecular profile of AC, so that we can develop more appropriate targeted therapies. Because of its rarity, international collaboration among clinical trials with translational components will be key to increasing cure rates and improving survivorship.