A comparison of pure adenocarcinoma and squamous cell carcinoma of the cervix after radical hysterectomy in stage IB–IIA

ObjectiveThis study was designed to investigate the survival difference between pure adenocarcinoma (AC) and squamous cell carcinoma (SCC) in early cervical cancer (FIGO stage IB–IIA) after radical hysterectomy with or without adjuvant therapy performed at a single institution.MethodsPatients with AC or SCC between November 1994 and September 2007 at the Samsung Medical Center, Sungkyunkwan University School of Medicine in Seoul, Korea were evaluated.ResultsAmong the 775 patients, 636 patients had SCC, and 139 patients had pure AC. In basal characteristics, preoperative FIGO stage, adjuvant therapy after surgery, as well as chemotherapeutic regimens, were not different between the two groups. However, the median age was about 5 years younger in pure AC patients than in SCC patients (44 years vs. 49 years, P = .001). In the comparison of pathological findings after surgery between the two groups, there were no differences between the two groups, except for LVSI status. The recurrence rate was higher in the pure AC group than in the SCC group (SCC; 36/636; 5.7%, AC; 20/139; 14.4%, P = < 0.001, respectively). The pure AC group had a higher recurrence rate in hematogenous/distant areas than the SCC group (SCC: 8/36; 22.2%, AC; 9/20; 45.0%, P = .076, respectively). In multivariable analysis, positive for pelvic LN and the pure AC cell type were independent factors in both DFS and OS.ConclusionWe observed that pure AC of the cervix might entail a worse survival outcome than SCC in patients with early cervical cancer (IB–IIA).

Research Highlights
► Pure adenocarcinoma of the cervix shows poor prognosis against squamous cell carcinoma.
► Recurrent patterns may be different based on histological subtypes in cervical cancer.
► Pure adenocarcinoma is an independent risk factor for survival in cervical cancer.