Noh, Jae Myoung; Park, Won; Kim, Young Seok; Kim, Joo-Young; Kim, Hak Jae; Kim, Juree; Kim, Jin Hee; Yoon, Mee Sun; Choi, Jin Hwa; Yoon, Won Sup; Kim, Ji-Yoon; Huh, Seung Jae
Gynecologic oncology
2014Mar ; 132 ( 3 ) :618-23.
PMID : 24486605
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Noh, Jae Myoung - Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-gu, Seoul 135-710, Republic of Korea.
Park, Won - Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-gu, Seoul 135-710, Republic of Korea. Electronic address wonro.park@samsung.com.
Kim, Young Seok - Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Republic of Korea.
Kim, Joo-Young - Proton Therapy Center, Research Institute and Hospital, National Cancer Center, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, Republic of Korea.
Kim, Hak Jae - Department of Radiation Oncology, Seoul National University College of Medicine, 103, Daehak-ro, Jongno-gu, Seoul 110-799, Republic of Korea.
Kim, Juree - Department of Radiation Oncology, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine, 17, Seoae-ro 1-gil, Jung-gu, Seoul 100-380, Republic of Korea.
Kim, Jin Hee - Department of Radiation Oncology, Dongsan Medical Center, Keimyung University School of Medicine, 56, Dalseong-ro, Jung-gu, Daegu 700-712, Republic of Korea.
Yoon, Mee Sun - Department of Radiation Oncology, Chonnam National University Medical School, 322, Seoyang-ro, Hwasun-eup, Hwasun-gun, Jeollanam-do 519-763, Republic of Korea.
Choi, Jin Hwa - Department of Radiation Oncology, College of Medicine, Chung-Ang University, 102, Heukseok-ro, Dongjak-gu, Seoul 156-755, Republic of Korea.
Yoon, Won Sup - Department of Radiation Oncology, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do 425-807, Republic of Korea.
Kim, Ji-Yoon - Department of Radiation Oncology, Yeoeuido St. Mary's Hospital, The Catholic University of Korea College of Medicine, 10, 63-ro, Yeongdeungpo-gu, Seoul 150-713, Republic of Korea.
Huh, Seung Jae - Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-gu, Seoul 135-710, Republic of Korea.
ABSTRACT
OBJECTIVE: To evaluate the prognostic influence of adenocarcinoma (AC) and adenosquamous carcinoma (ASC) in patients with FIGO stage IB-IIA cervical cancer who received radical hysterectomy followed by adjuvant radiotherapy (RT) or concurrent chemoradiotherapy (CCRT).
METHODS: We analyzed 1323 patients who satisfied the following criteria: histologically proven squamous cell carcinoma (SCC), AC, or ASC of the uterine cervix; FIGO stage IB-IIA disease; no history of neoadjuvant chemotherapy; and a history of radical hysterectomy with pelvic lymph node (PLN) dissection, followed by postoperative pelvic RT at a dose ??45 Gy. The median age was 50 years. Median RT dose delivered to the whole pelvis was 50.4 Gy, and 219 (16.6%) patients received brachytherapy at a median dose of 24 Gy. Concurrent chemotherapy was delivered to 492 (37.2%) patients.
RESULTS: Pathologic risk factors were not different according to pathologic subtype. The median follow-up duration was 75.7 months. Locoregional recurrence-free survival, relapse-free survival (RFS), and overall survival were significantly affected by histology, tumor size, PLN metastasis, parametrial invasion, lymphovascular invasion, and deep stromal invasion. The 5-year RFS rates were 83.7%, 66.5%, and 79.6% in patients with SCC, AC, and ASC histology, respectively (P<0.0001). By multivariate analysis, AC histology was the only significant prognostic factor affecting all survival outcomes.
CONCLUSIONS: AC histology was associated with poor survival outcomes in patients with FIGO stage IB-IIA cervical cancer who received adjuvant RT or CCRT. Prognosis of ASC histology was closer to that of SCC histology than that of AC histology. CI - Copyright ??2014 Elsevier Inc. All rights reserved.
keyword
Adenocarcinoma; Adenosquamous carcinoma; Cervical cancer; Postoperative radiotherapy
MESH
Adenocarcinoma/pathology/radiotherapy/surgery, Adult, Aged, Aged, 80 and over, Carcinoma, Adenosquamous/pathology/radiotherapy/surgery, Female, Humans, Hysterectomy, Middle Aged, Neoplasm Staging, Radiotherapy, Adjuvant, Retrospective Studies, Survival Rate, Treatment Outcome, Uterine Cervical Neoplasms/pathology/*radiotherapy/*surgery, Young Adult
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