Gastric-Type Adenocarcinoma of the Uterine Cervix
| Autor: | Kyoung-Sik Cho, Mi-Hyun Kim, Jeong Kon Kim, Kye Jin Park |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
medicine.medical_specialty Lymphovascular invasion Uterine Cervical Neoplasms Kaplan-Meier Estimate Stromal Invasion Young Adult 03 medical and health sciences 0302 clinical medicine medicine Humans Cyst Stage (cooking) Neoplasm Staging Proportional Hazards Models Retrospective Studies Neoplasm Grading 030219 obstetrics & reproductive medicine medicine.diagnostic_test Parametrial business.industry Obstetrics and Gynecology Magnetic resonance imaging Prognosis medicine.disease Adenocarcinoma Mucinous Magnetic Resonance Imaging Oncology Case-Control Studies 030220 oncology & carcinogenesis Adenocarcinoma Female Radiology business |
| Zdroj: | International Journal of Gynecological Cancer. 28:1203-1210 |
| ISSN: | 1048-891X |
| DOI: | 10.1097/igc.0000000000001275 |
| Popis: | Gastric-type mucinous adenocarcinoma (GAS) of uterine cervix has been suggested as distinct clinicopathologic behavior. Our study aimed to investigate the distinguishing imaging features and clinical outcomes of GAS.Fifteen cases of GAS and 45 cases of 3:1 age-matched usual-type endocervical carcinoma (UEA) were assessed. Clinical parameters (age, tumor size, clinical stage, and time to recurrence [TTR] or death) and pathologic results confirmed by surgery were recorded. Imaging features (tumor shape, margin, presence of vaginal involvement, or cyst) on magnetic resonance T2-weighed images were evaluated by consensus reading. Parametrial invasion was assessed by 2 independent readers on a 4-point scale system.Gastric-type mucinous adenocarcinomas were associated with a higher stage at presentation and higher rates of deep cervical stromal invasion, parametrial invasion, and lymphovascular invasion. On magnetic resonance images, GASs also demonstrated a more infiltrative shape (93.3% vs 22.2%; P0.001) with/without cysts, ill-defined margin (93.3% vs 31.8%; P0.001), endocervical location (46.7%) or extension to the entire cervix (46.7%), higher rates of vaginal involvement (40.0% vs 4.4%; P = 0.002), and higher grade of parametrial invasion by both readers (66.7% vs 22.2%; P = 0.003) compared with UEAs. Patients with GAS had a significantly shorter TTR compared with UEA cases (P0.001) by log-rank test. A multivariate Cox proportional hazards model revealed that an infiltrative tumor shape (hazard ratio, 5.92; P = 0.004) and stage II or greater (hazard ratio, 4.19; P = 0.011) were prognostic indicators of a shorter TTR.Gastric-type mucinous adenocarcinoma may have characteristic imaging features and poorer outcomes compared with UEA. |
| Databáze: | OpenAIRE |
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