Seki Toshiyuki, Kojima Atsumi, Okame Shinichi, Yamaguchi Satoshi, Okamoto Aikou, Tokunaga Hideki, Nishio Shin, Takei Yuji, Yokoyama Yoshihito, Yoshida Manabu, Teramoto Norihiro, Mikami Yoshiki, Shimada Muneaki, Kigawa Junzo, Takehara Kazuhiro
Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Tokyo 105-8461, Japan.
Department of Obstetrics and Gynecology, Iwate Medical University, Yahaba 028-3695, Japan.
Cancers (Basel). 2023 Mar 12;15(6):1730. doi: 10.3390/cancers15061730.
The revised World Health Organization classification of cervical cancer divides adenocarcinomas into human papillomavirus-associated (HPVa) and -independent (HPVi) types; the HPVi type is represented by the gastric type. The treatment outcomes of locally advanced adenocarcinoma (LaAC), based on this classification, are understudied. We investigated the outcomes of patients with HPVa and HPVi LaACs. Data for all consecutive patients with stage IB3 to IIIC1 adenocarcinoma who received treatment at 12 institutions throughout Japan between 2004 and 2009 were retrieved to analyze progression-free and overall survival. Central pathological review classified 103 and 48 patients as having HPVa and HPVi tumors, respectively. Usual- (84%) and gastric- (90%) type adenocarcinomas were the most frequent subtypes. Surgery was the primary treatment strategy for most patients. Progression-free and overall survival of patients with HPVi were worse than those of patients with HPVa ( = 0.009 and 0.032, respectively). Subgroup analysis by stage showed that progression-free survival was significantly different for stage IIB. The current surgical treatment strategy for LaACs is less effective for HPVi tumors than for HPVa tumors, especially those in stage IIB.
世界卫生组织修订的宫颈癌分类将腺癌分为人乳头瘤病毒相关（HPVa）型和非相关（HPVi）型；HPVi型以胃型为代表。基于这种分类，局部晚期腺癌（LaAC）的治疗结果研究不足。我们调查了HPVa和HPVi LaAC患者的治疗结果。检索了2004年至2009年期间在日本12家机构接受治疗的所有连续IB3至IIIC1期腺癌患者的数据，以分析无进展生存期和总生存期。中心病理审查将103例和48例患者分别分类为患有HPVa和HPVi肿瘤。常见型（84%）和胃型（90%）腺癌是最常见的亚型。手术是大多数患者的主要治疗策略。HPVi患者的无进展生存期和总生存期均比HPVa患者差（分别为P = 0.009和0.032）。按分期进行的亚组分析显示，IIB期患者的无进展生存期存在显著差异。目前针对LaAC的手术治疗策略对HPVi肿瘤的效果比对HPVa肿瘤差，尤其是IIB期的肿瘤。
