Glassy cell carcinoma of the uterine cervix

Abstract

15050 Background: Glassy Cell Carcinoma of the uterine cervix is a rare, aggressive form of cervical cancer accounting for only 1–5% of all cervical carcinomas. To date, there is no consensus on treatment modalities, but most advocate for a more aggressive treatment strategy including both radical surgery and radiation therapy. The objective of this study was to analyze the clinical features, treatment, and outcome of patients with Glassy cell carcinoma diagnosed at our institution. We hypothesized that such aggressive therapies yield survival benefits which approximate those of the more common squamous cell carcinomas of the cervix. Methods: In collaboration with the Department of Radiation Oncology at Rhode Island Hospital, a retrospective comprehensive chart review of all patients diagnosed with Glassy cell carcinoma of the cervix between the years 1993 and 2005 was undertaken at Women and Infant’s Hospital, Providence, RI. All cases were assessed for clinicopathologic features, treatment strategies, and outcome, including progression free survival and overall survival rates. Results: Twenty-eight patients with biopsy proven Glassy Cell Carcinoma of the cervix were identified. Eleven (39%) were less than age 40, and five (18%) were less than age 30. Of these, 19 were either stage IB or IIA, and 15/19 (79%) received multimodality therapy, a combination of radiation, chemotherapy, and surgery, as initial treatment. When survival was broken down by mode of treatment, 25% of patients who received single modality treatment (either surgery or radiation) were DF at two and five years. In contrast, those patients who were treated with bimodal therapy had a DFS of 93% at 2 years and 84% at 5 years. Thus the survival of patients with glassy cell histology treated at our institution with multimodality therapy approximates the survival of similar stage patients with squamous and adenocarcinoma, with a mean follow-up of greater than 5 years. This represents a distinct improvement when compared to national survival statistics. Conclusions: The favorable survival results of this aggressively treated population, supports the belief that multimodality therapy is preferable in patients with glassy cell carcinoma of the cervix even in early stage disease. However, optimal treatment regimens have yet to be determined and is a field for further study. No significant financial relationships to disclose.