Clinical study of 16 cases of villoglandular adenocarcinoma of uterine cervix

Abstract

To explore the clinicopathologic features, managements and outcomes of villoglandular adenocarcinoma (VA) of uterine cervix. From June 2009 to January 2014, a total of 16 cases of VA were reviewed retrospectively. Their mean age was 41.4 (30-56) years. The major symptoms were post-coital hemorrhage or abnormal vaginal hemorrhage (10/16). And the International Federation of Gynecology and Obstetrics (FIGO) stages were Ia1 (n = 1),Ib1 (n = 12),Ib2 (n = 2) and IIa1 (n = 1).One patient of Ia1 stage underwent laparoscopic total hysterectomy and bilateral salpingo-oophorectomy (BSO) after conization; one patient of Ib1 stage total abdominal hysterectomy and BSO after radiotherapy and concurrent chemotherapy while another one of Ib1 stage radical vaginal trachelectomy; one pregnancy-associated patient of Ib1 stage was diagnosed at 12 weeks' gestation and underwent cesarean radical hysterectomy plus pelvic lymphadenectomy after four courses of chemotherapy. Aand the remainder underwent radical hysterectomy plus pelvic lymphadenectomy.None of 14 cases with a known status of lymph node status had positive nodes. And 1/13 cases undergoing ovariectomy had pathologically confirmed cervical cancer metastasis of ovarian surface and the remainder and another patient of ovarian biopsy had negative results for lymph nodes. The median follow-up period was 23.3 (5-60) months. All patients survived and there was one recurrent case of vaginal stump mass at 8 months after initial surgery. The overall and disease-free 5-year survival was 100% and 94% (15/16) respectively. VA mainly affects younger women and prognosis is generally fair with a lower rate of ovarian metastasis compared to common forms of cervical cancer. Due to a limited sample size and clinical data are studied retrospectively, multi-center prospective studies are warranted for a better understand of this disease.