Locally advanced adenocarcinoma and adenosquamous carcinoma of the cervix compared to squamous cell carcinoma of the cervix in Gynecologic Oncology Group trials of chemoradiation.

Abstract

5530 Background: Conflicting results have been reported for adeno- and adenosquamous carcinomas the cervix with respect to their response to therapy and prognosis. Adeno- and adenosquamous carcinoma comprise the majority of non-squamous carcinomas of the cervix enrolled in GOG trials of chemoradiation. Methods: Adeno- and adenosquamous cervical carcinomas were retrospectively studied and compared to squamous cell carcinomas in GOG trials of chemoradiation. Results: Among 1672 patients enrolled in clinical trials of chemoradiation, 182 adeno- and adenosquamous carcinomas were identified (10.8%). A higher percentage of adeno- and adenosquamous carcinomas were stage IB (27% versus 20%) and fewer were stage IIIB (21.4% versus 28.6%). The mean tumor size was larger for squamous than adeno- and adenosquamous carcinomas, but adeno- and adenosquamous carcinomas were more often poorly differentiated (46.2% versus 26.8%). Among patients that received cis-platinum during radiation therapy, 843 with squamous cell carcinoma were compared to 112 with adeno- or adenosquamous carcinoma for overall survival, with no significant difference in risk of death (p=0.472). However, among patients that did not receive cis-platinum, 647 with squamous cell carcinoma and 70 with adeno- or adenosquamous carcinoma, there was a slightly higher risk of death for the adeno- or adenosquamous group (p=0.049). Adverse effects to treatment were similar across histologies. Conclusions: Patients with adeno- and adenosquamous carcinomas of the cervix have worse overall survival when treated with radiation alone, but have progression-free and overall survival similar to patients with squamous cell carcinomas of the cervix when treated with cis-platinum based chemoradiation.