Wang Ting, Lu Zhiying, Zhang Xiaodan, Hua Keqin
Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, 200090, People's Republic of China.
Int J Gen Med. 2022 May 3;15:4625-4634. doi: 10.2147/IJGM.S358094. eCollection 2022.
Clear cell adenocarcinoma of the cervix (CCAC) is a rare pathological type of cervical cancer. This study aimed to report our clinical experience with CCAC treatment and analyze the factors associated with patient survival.
This single-center study included patients diagnosed with CCAC and treated between 01/2003 and 12/2017 at the Obstetrics and Gynecology Hospital of Fudan University. The patients diagnosed with CCAC that underwent radical resection were included. The Kaplan-Meier method and multivariable Cox regression analysis were performed to determine factors associated with patient survival.
Fifty-four patients were included. None were exposed to diethylstilbestrol. The median follow-up was 96 (13.0, 120.0) months. The median recurrence-free survival (RFS) and overall survival (OS) were 68 and 78 months, respectively. Positive pelvic lymph nodes (HR=2.87, 95% confidence interval [CI] 1.14-7.22, P=0.03), tumor size >4 cm (HR=3.31, 95% CI 1.35-8.12, P=0.01), International Federation of Gynecology and Obstetrics (FIGO) IB2-IIA2 stage (HR=2.49, 95% CI 1.56-3.99, P=0.02), and postoperative therapy (HR=1.73, 95% CI 1.07-2.81, P=0.03) were associated with OS. Multivariable analysis showed that FIGO stage IB2-IIA2 (HR=2.36, 95% CI 1.52-3.68, P<0.01) and lymph node status (HR=3.05, 95% CI 1.12-8.28, P=0.03) were independently associated with OS.
Advanced FIGO stage and positive lymph node status are independently associated with shorter survival in patients with CCAC who were not exposed to diethylstilbestrol. After surgery, chemotherapy and concurrent chemoradiotherapy were not independently associated with the prognosis of patients with CCAC.
宫颈透明细胞腺癌（CCAC）是一种罕见的宫颈癌病理类型。本研究旨在报告我们治疗CCAC的临床经验，并分析与患者生存相关的因素。
这项单中心研究纳入了2003年1月至2017年12月期间在复旦大学附属妇产科医院诊断为CCAC并接受治疗的患者。纳入接受根治性切除的CCAC患者。采用Kaplan-Meier法和多变量Cox回归分析来确定与患者生存相关的因素。
共纳入54例患者。均未接触过己烯雌酚。中位随访时间为96（13.0，120.0）个月。中位无复发生存期（RFS）和总生存期（OS）分别为68个月和78个月。盆腔淋巴结阳性（HR = 2.87，95%置信区间[CI] 1.14 - 7.22，P = 0.03）、肿瘤大小>4 cm（HR = 3.31，95% CI 1.35 - 8.12，P = 0.01）、国际妇产科联盟（FIGO）IB2-IIA2期（HR = 2.49，95% CI 1.56 - 3.99，P = 0.02）以及术后治疗（HR = 1.73，95% CI 1.07 - 2.81，P = 0.03）与总生存期相关。多变量分析显示，FIGO分期IB2-IIA2（HR = 2.36，95% CI 1.52 - 3.68，P<0.01）和淋巴结状态（HR = 3.05，95% CI 1.12 - 8.28，P = 0.03）与总生存期独立相关。
对于未接触过己烯雌酚的CCAC患者，晚期FIGO分期和阳性淋巴结状态与较短生存期独立相关。术后，化疗和同步放化疗与CCAC患者的预后无独立相关性。
