Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume, Japan.
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA.
Eur J Surg Oncol. 2022 Sep;48(9):2039-2044. doi: 10.1016/j.ejso.2022.03.007. Epub 2022 Mar 25.
Gastric-type mucinous carcinoma (GAS) is a novel variant of uterine cervix mucinous carcinoma. GAS is a distinct entity that can be distinguished from typical endocervical adenocarcinoma (UEA). In Japan, postoperative adjuvant therapy for cervical cancer includes not only radiation therapy (RT) or concurrent chemoradiotherapy (CCRT) but also chemotherapy in many cases. However, no previous studies have analyzed adjuvant therapy for GAS. In the present study, we investigated the efficacy of adjuvant therapy for GAS.
This was a preplanned secondary analysis of a dataset from previous nationwide, retrospective, observational study. The study population comprised women with stage I-II GAS who underwent surgery. Progression-free survival (PFS) and overall survival (OS) were compared among patients who did and did not receive adjuvant therapy using the Kaplan-Meier method.
Data were analyzed for a total of 102 enrolled patients, who were classified as low- (17 patients), intermediate- (37 patients), or high risk (48 patients) based on the risk of postoperative cervical cancer recurrence. In the intermediate-risk group, median survival could not be assessed due to a lack of sufficient events, but the no-adjuvant and RT groups tended to exhibit better prognoses. In contrast, within the high-risk group, patients in the RT subgroup exhibited a trend towards better PFS and OS than those in the CCRT and chemotherapy groups.
The prognosis of GAS was confirmed to be poor, even in cases of early-stage cancer and following surgical resection. Chemotherapy strategies, including CCRT as postoperative adjuvant therapy, tend to have a poor prognosis.
胃型黏液性宫颈癌（GAS）是宫颈黏液性癌的一种新型变体。GAS 是一种独特的实体，可以与典型的宫颈内膜腺癌（UEA）区分开来。在日本，宫颈癌的术后辅助治疗不仅包括放疗（RT）或同期放化疗（CCRT），而且在许多情况下还包括化疗。然而，以前没有研究分析过 GAS 的辅助治疗。在本研究中，我们研究了 GAS 的辅助治疗效果。
这是对先前全国性回顾性观察性研究数据集的预先计划的二次分析。研究人群包括接受手术治疗的 I 期-II 期 GAS 女性患者。使用 Kaplan-Meier 方法比较接受和未接受辅助治疗的患者的无进展生存期（PFS）和总生存期（OS）。
共分析了 102 名入组患者的数据，这些患者根据术后宫颈癌复发风险分为低危（17 名患者）、中危（37 名患者）或高危（48 名患者）。在中危组中，由于缺乏足够的事件，中位生存期无法评估，但无辅助治疗和 RT 组的预后似乎更好。相比之下，在高危组中，RT 亚组的患者在 PFS 和 OS 方面的预后要好于 CCRT 和化疗组。
即使在早期癌症和手术后，GAS 的预后也被证实很差。包括 CCRT 在内的化疗策略作为术后辅助治疗，往往预后较差。
