Clinicopathological characteristics and prognosis of 118 cases of cervical adenocarcinoma with stage Ib1-IIb treated with radical hysterectomy and systematic lymphadenectomy

Abstract

Objective To evaluate the clinicopathological characteristics and prognosis of cervical adenocarcinoma patients with stage Ⅰb1-Ⅱb treated with radical hysterectomy and systematic lymphadenectomy. Methods The clinical, pathologic and follow-up data of 118 cases of cervical adenocarcinoma with stage Ib1-IIb treated with radical hysterectomy and systematic lymphadenectomy in Cancer Hospital of Shantou University Medical College from Dec.2003 to Nov.2015 were analyzed retrospectively. Results 118 patients of cervical adenocarcinoma with stage Ⅰb1-Ⅱb had a median age of 46 years at diagnosis.28 cases were postmenopausal and 90 cases were premenopausal. There were 77 cases in phase Ⅰb1, 25 in stage Ⅰb2, 4 in stage Ⅱa1, 7 in stage Ⅱa2, 5 in stage Ⅱb. The rate of ovarian metastasis was 3.39%.The 3-year recurrence-free survival rate of the patients was 81.6%.The 3-year overall survival rate of the patients was 83.9% , and 89.10% for stage Ⅰb1, 73.7%for stage Ⅰb2, 100% for stage Ⅱa1, 83.3% for stage Ⅱa2, 60.0% for stageⅡb.The 3-year overall survival rates of the patients who receive non-chemoradiotherapy, chemotherapy, radiotherapy and chemoradiotherapy after operation were 90.6%, 100%, 84.6% and 70% respectively.The result of Cox proportional hazards regression model analysis indicated that lymph lode metastasis and ovarian metastasis was the independent prognostic factor of desease-free survival, ovarian metastasis and deep myometrial invasion was the independent prognostic factor of overall survival. Conclusions Premenopausal cases are more common than postmenopausal cases in cervical adenocarcinoma with stage Ⅰb1-Ⅱb.Ovarian presevation is feasible for early-stage cervical denocarcinoma after full assessment. Pelvic irradiation with concurrent chemotherapy can lead a better prognosis for the patients with pathological risk factors. Key words: Uterine cervical neoplasms/PA; Adenocarcinoma/PA; Prognosis