Prognostic factors and adjuvant therapy on survival in early-stage cervical adenocarcinoma/adenosquamous carcinoma after primary radical surgery: A Taiwanese Gynecologic Oncology Group (TGOG) study

Nae Fang Twu, Yu Che Ou, Cheng I. Liao, Wei Yang Chang, Lan Yan Yang, Yun Hsin Tang, Tze Chien Chen, Chi Hau Chen, Tze Ho Chen, Lain Shung Yeh, Shih Tien Hsu, Yu Chieh Chen, Cheng Chang Chang, Ya Min Cheng, Chia Yen Huang, Fu Shing Liu, Yue Shan Lin, Sheng Mou Hsiao, Yuan Yee Kan, Chyong Huey Lai

Research output: Contribution to journalReview articlepeer-review

14 Citations (Scopus)

Abstract

Objective We aimed to identify prognostic factors of early-stage cervical adenocarcinoma (AC) and adenosquamous carcinoma (ASC) treated with primary radical surgery, and to evaluate the impact of postoperative adjuvant therapy on outcome. Methods The clinical-pathological data of all patients (n = 1132) with stages I-II cervical AC/ASC treated with primary radical surgery at the member hospitals of the Taiwanese Gynecologic Oncology Group were retrospectively reviewed. Results In multivariate analysis, stage II, deep stromal invasion (DSI), lymphovascular space invasion (LVSI), positive pelvic lymph node (PLN), and parametrial involvement (PI) were significant factors for recurrence-free survival (RFS), while only DSI, PI, and positive PLN were independent factors for cancer-specific survival (CSS). Low- and high-risk groups were defined by prognostic scores derived from the four factors (DSI, LVSI, positive PLN, PI) selected by internal validation. Postoperative adjuvant therapy significantly improved outcome for PLN-positive patients (RFS, p = 0.014; CSS, p = 0.016), but not for PLN-negative high-risk group because of higher mean prognostic score (p = 0.028) of adjuvant+ than adjuvant- patients. Conclusions PLN metastasis, PI, DSI, and LVSI were independent prognostic factors. Prospective studies of postoperative adjuvant therapy with prognostic score and nodal status stratification for cervical AC/ASC are necessary.

Original languageEnglish
Pages (from-to)229-235
Number of pages7
JournalSurgical Oncology
Volume25
Issue number3
DOIs
Publication statusPublished - 2016 Sep 1

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

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