The prognostic value of histologic subtype in node-positive early-stage cervical cancer after hysterectomy and adjuvant radiotherapy.

Autor: Zhou J; Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, Xiamen 361003, People's Republic of China., Zhang WW; Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou 510060, People's Republic of China., Wu SG; Department of Radiation Oncology, Xiamen Cancer Hospital, The First Affiliated Hospital of Xiamen University, Xiamen 361003, People's Republic of China., He ZY; Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou 510060, People's Republic of China., Sun JY; Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou 510060, People's Republic of China., Yang GF; Department of Gynecology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, People's Republic of China. Electronic address: pgf_yang@126.com., Li FY; Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou 510060, People's Republic of China. Electronic address: lify@sysucc.org.cn.
Jazyk: angličtina
Zdroj: International journal of surgery (London, England) [Int J Surg] 2017 Aug; Vol. 44, pp. 1-6. Date of Electronic Publication: 2017 Jun 02.
DOI: 10.1016/j.ijsu.2017.05.074
Abstrakt: Background: To assess the survival outcomes in patients with International Federation of Gynecology and Obstetrics (FIGO) stage I-IIA adenocarcinoma (AC) or squamous cell carcinoma (SCC) of the uterine cervix after hysterectomy and adjuvant radiotherapy (RT).
Methods: Patients with a primary diagnosis of FIGO stage I-IIA AC or SCC of the uterine cervix after hysterectomy and adjuvant RT between 1988 and 2012 were included using data from the Surveillance, Epidemiology, and End Results database. Univariate and multivariate Cox regression analyses were used to analyze the effect of histologic subtype on cause-specific survival (CSS) and overall survival (OS).
Results: We included 1171 patients: 919 with cervical SCC and 252 with cervical AC. In multivariate analysis, cervical AC was an independent adverse prognostic factor for survival. Patients with cervical AC had worse CSS (p = 0.001) and OS (p = 0.001) compared to patients with cervical SCC. In the subgroup analysis, patients with cervical SCC in the era of concurrent chemoradiotherapy (CCRT) (2000-2012) had better CSS (p = 0.006) and OS (p = 0.004) compared with the era of RT. However, there was no significant difference in CSS (p = 0.079) and OS (p = 0.053) between the eras of RT (1988-1999) and CCRT for patients with cervical AC.
Conclusions: Survival of cervical AC is significantly worse than that of cervical SCC. As CCRT usage increases, the survival benefit is derived only in cervical SCC, but not in cervical AC.
(Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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