Should Adenocarcinoma of Cervix be Treated Differently to Squamous Cell Carcinoma?

Indian Journal of Gynecologic Oncology volume 19, Article number: 22 (2021) Cite this article

Abstract

Aim

The purpose of this study was to evaluate the overall survival (OS), relapse-free survival (RFS) and patterns of failure, in patients with SCC and ADC of cervix treated with definitive radiotherapy and to determine whether ADC should be treated differently.

Methods

Total of 494 patients treated between January 1996 and December 2012 with definitive radiotherapy were included for analysis. Survival probabilities were estimated using Kaplan–Meier method, and differences between the groups were compared using long-rank test. Cox proportional hazards models were used to determine the role of histology after adjusting for potential confounders impacting on survival.

Results

The 5-year RFS of node-negative SCC and ADC was 79% and 75% and of node-positive SCC and ADC was 51% and 37%, respectively. The 5-year OS was 74% for both node-negative SCC and ADC and 54% and 42% for node-positive SCC and ADC, respectively. This difference in RFS and OS among these four subgroups was not significant. The tumour volume (p = 0.005), corpus invasion (p = 0.022) and lymph node involvement (p < 0.001) were significant predictors of RFS, whereas histology (p = 0.204) was not. Increasing age (p < 0.001), ECOG performance score 2 (p = 0.04), tumour volume (p = 0.009) and lymph node involvement (p < 0.001) were predictive for OS, but histology (p = 0.458) was not. There was no difference in pelvic and extra-pelvic failure of the two histological subtypes.

Conclusion

Both these histological types exhibit similar clinical behaviour and survival when matched for prognostic factors. Hence, current standard of care was equally effective in both histological types.

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Availability of Data and Material

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Funding

No funding was obtained for this study.

Author information

Affiliations

  1. Gynae-Oncology Unit, Department of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Australia

    Ming Yin Lin, Chrishanthi Rajasooriyar, Srinivas Kondalsamy-Chennakesavan & Kailash Narayan

  2. Teaching Hospital, Jaffna, Sri Lanka

    Chrishanthi Rajasooriyar

  3. Tellipalai Trail Cancer Hospital, Jaffna, Sri Lanka

    Chrishanthi Rajasooriyar

  4. Rural Clinical School, Faculty of Medicine, The University of Queensland, Brisbane, Australia

    Srinivas Kondalsamy-Chennakesavan

  5. Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia

    Kailash Narayan

  6. ICON Cancer Centre, East Melbourne, Australia

    Kailash Narayan

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  1. Ming Yin Lin
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  2. Chrishanthi Rajasooriyar
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  3. Srinivas Kondalsamy-Chennakesavan
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  4. Kailash Narayan
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Correspondence to Chrishanthi Rajasooriyar or Kailash Narayan.

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Ethical clearance was obtained from the ‘Ethics review committee’, “Institutional Review Board” of the Peter MacCallum Cancer Centre, Melbourne, Australia, Faculty of Medicine, University of Jaffna, Sri Lanka; approval number: 16/86R J/ERC/14/51/NDR/00800.

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Lin, M.Y., Rajasooriyar, C., Kondalsamy-Chennakesavan, S. et al. Should Adenocarcinoma of Cervix be Treated Differently to Squamous Cell Carcinoma?. Indian J Gynecol Oncolog 19, 22 (2021). https://doi.org/10.1007/s40944-021-00503-1

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Keywords

  • Cervix cancer
  • Squamous carcinoma
  • Adenocarcinoma