1. Impact of histological subtype on survival in patients with locally advanced cervical cancer that were treated with definitive radiotherapy: adenocarcinoma/adenosquamous carcinoma versus squamous cell carcinoma
- Author
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Yuri Matsumoto, Ryoko Takahashi, Tadashi Kimura, Katsumi Kozasa, Eriko Yokoi, Hiromasa Kuroda, and Seiji Mabuchi
- Subjects
Adult ,0301 basic medicine ,Oncology ,medicine.medical_specialty ,Multivariate analysis ,Adenosquamous carcinoma ,medicine.medical_treatment ,Locally advanced ,Uterine Cervical Neoplasms ,Antineoplastic Agents ,Adenocarcinoma ,Cervix ,Carcinoma, Adenosquamous ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Aged ,Neoplasm Staging ,Proportional Hazards Models ,Retrospective Studies ,Cervical cancer ,Radiotherapy ,business.industry ,Obstetrics and Gynecology ,Histology ,Chemoradiotherapy ,General Medicine ,Middle Aged ,medicine.disease ,Radiation therapy ,030104 developmental biology ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Multivariate Analysis ,Carcinoma, Squamous Cell ,Female ,Original Article ,Cisplatin ,Neoplasm Recurrence, Local ,business - Abstract
Objective To compare the survival outcomes of patients with cervical squamous cell carcinoma (SCC) and adenocarcinoma/adenosquamous carcinoma (AC/ASC) among patients with locally advanced cervical cancer that were treated with definitive radiotherapy. Methods The baseline characteristics and outcome data of patients with locally advanced cervical cancer who were treated with definitive radiotherapy between November 1993 and February 2014 were collected and retrospectively reviewed. A Cox proportional hazards regression model was used to investigate the prognostic significance of AC/ASC histology. Results The patients with AC/ASC of the cervix exhibited significantly shorter overall survival (OS) (p=0.004) and progression-free survival (PFS) (p=0.002) than the patients with SCC of the cervix. Multivariate analysis showed that AC/ASC histology was an independent negative prognostic factor for PFS. Among the patients who displayed AC/ASC histology, larger tumor size, older age, and incomplete response to radiotherapy were found to be independent prognostic factors. PFS was inversely associated with the number of poor prognostic factors the patients exhibited (the estimated 1-year PFS rates; 100.0%, 77.8%, 42.8%, 0.0% for 0, 1, 2, 3 factors, respectively). Conclusion Locally advanced cervical cancer patients with AC/ASC histology experience significantly worse survival outcomes than those with SCC. Further clinical studies are warranted to develop a concurrent chemoradiotherapy (CCRT) protocol that is specifically tailored to locally advanced cervical AC/ASC.
- Published
- 2017
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